How much rates vary
Facilitymedian $1,259 · 10th to 90th $501 to $7,586Professionalmedian $2,630 · 10th to 90th $1,778 to $4,467
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 $2,137.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,137.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $3,388.44 | Professional | None | $2,089.30 | $2,137.96 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,089.30 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,630.27 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,659.59 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,174.90 | $1,659.59 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $426.58 Typical High $707.95 | Professional | 80 · Assistant surgeon | $302.00 | $426.58 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $371.54 Typical High $602.56 | Professional | AS · PA/NP assist | $263.03 | $371.54 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $5,623.41 | Professional | None | $2,187.76 | $3,090.30 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $4,365.16 | Professional | None | $2,137.96 | $2,344.23 | $4,365.16 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,754.23 Typical High $6,456.54 | Professional | None | $1,737.80 | $2,754.23 | $6,456.54 |
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 $1,047.13 Median $1,071.52 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,621.81 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,621.81 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $323.59 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $213.80 Typical High $263.03 | Professional | 56 · Pre-op care only | $208.93 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,513.56 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,513.56 | $1,819.70 |
Where Georgia sits
The same service costs 7.8 times more in Alabama than in Washington. 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
AL $20,353WA $2,608
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.