How much rates vary
Facilitymedian $2,951 · 10th to 90th $708 to $7,762Professionalmedian $891 · 10th to 90th $589 to $1,549
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 $676.08 Median $5,370.32 Typical High $7,943.28 | Facility | None | $676.08 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,778.28 | Professional | None | $660.69 | $707.95 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,380.38 | Professional | None | $549.54 | $891.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,445.44 Typical High $2,089.30 | Professional | 50 · Both sides | $954.99 | $1,445.44 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $616.60 Typical High $870.96 | Professional | 62 · Two surgeons | $407.38 | $616.60 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $165.96 Typical High $239.88 | Professional | 80 · Assistant surgeon | $100.00 | $165.96 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $131.83 Typical High $199.53 | Professional | AS · PA/NP assist | $95.50 | $131.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $4,570.88 | Facility | None | $602.56 | $3,630.78 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $1,995.26 | Professional | None | $691.83 | $1,288.25 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $2,344.23 | Professional | None | $616.60 | $707.95 | $2,344.23 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,995.26 | Professional | None | $630.96 | $1,000.00 | $1,995.26 |
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 $331.13 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $575.44 |
Where Georgia sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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 $10,313MT $1,845
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.