How much rates vary
Facilitymedian $3,548 · 10th to 90th $457 to $10,715Professionalmedian $4,074 · 10th to 90th $3,388 to $6,457
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,548.13 Median $4,677.35 Typical High $4,677.35 | Facility | None | $3,548.13 | $4,677.35 | $4,677.35 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $5,248.07 | Professional | None | $4,466.84 | $4,677.35 | $5,248.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $5,623.41 | Professional | None | $3,388.44 | $3,981.07 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $2,511.89 Typical High $3,467.37 | Professional | 62 · Two surgeons | $2,187.76 | $2,511.89 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $630.96 Typical High $870.96 | Professional | 80 · Assistant surgeon | $549.54 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $562.34 Typical High $758.58 | Professional | AS · PA/NP assist | $478.63 | $562.34 | $758.58 |
CareSource Setting Facility Modifier None Typical Low $3,801.89 Median $4,570.88 Typical High $7,079.46 | Facility | None | $3,801.89 | $4,570.88 | $7,079.46 |
CareSource Setting Professional Modifier None Typical Low $4,466.84 Median $6,165.95 Typical High $7,413.10 | Professional | None | $4,466.84 | $6,165.95 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $9,120.11 | Professional | None | $3,981.07 | $3,981.07 | $9,120.11 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $8,709.64 | Professional | None | $3,388.44 | $4,466.84 | $8,709.64 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2,290.87 Median $2,344.23 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,290.87 | $2,344.23 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 53 · Discontinued | $933.25 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,548.13 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,467.37 | $3,548.13 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $707.95 Typical High $776.25 | Professional | 55 · Aftercare only | $691.83 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | 56 · Pre-op care only | $457.09 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,311.31 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,311.31 | $3,630.78 |
Where Kentucky sits
The same service costs 8.4 times more in Wisconsin than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $28,671TX $3,407
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.