How much rates vary
Facilitymedian $1,259 · 10th to 90th $501 to $7,586Professionalmedian $3,548 · 10th to 90th $2,399 to $6,166
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 $2,884.03 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,884.03 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,754.23 | $2,884.03 | $3,801.89 |
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 $2,398.83 Median $3,548.13 Typical High $5,754.40 | Professional | None | $2,398.83 | $3,548.13 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,238.72 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,659.59 | $2,238.72 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $602.56 Typical High $954.99 | Professional | 80 · Assistant surgeon | $416.87 | $602.56 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $501.19 Typical High $831.76 | Professional | AS · PA/NP assist | $371.54 | $501.19 | $831.76 |
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 $2,951.21 Median $4,073.80 Typical High $7,585.78 | Professional | None | $2,951.21 | $4,073.80 | $7,585.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $4,897.79 | Professional | None | $2,818.38 | $3,090.30 | $4,897.79 |
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 $2,630.27 Median $3,981.07 Typical High $9,332.54 | Professional | None | $2,630.27 | $3,981.07 | $9,332.54 |
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 $1,380.38 Median $1,445.44 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,380.38 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $575.44 Typical High $691.83 | Professional | 53 · Discontinued | $549.54 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,137.96 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,089.30 | $2,137.96 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $426.58 Typical High $512.86 | Professional | 55 · Aftercare only | $416.87 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $288.40 Typical High $346.74 | Professional | 56 · Pre-op care only | $275.42 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,995.26 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,995.26 | $2,398.83 |
Where Georgia sits
The same service costs 7.1 times more in Alaska 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
AK $22,023WA $3,113
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.