How much rates vary
Facilitymedian $1,259 · 10th to 90th $603 to $8,511Professionalmedian $646 · 10th to 90th $501 to $1,148
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 $602.56 Median $691.83 Typical High $794.33 | Facility | None | $602.56 | $691.83 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,258.93 | Professional | None | $602.56 | $691.83 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $11,220.18 | Facility | None | $758.58 | $8,912.51 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $812.83 | Professional | None | $501.19 | $602.56 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $912.01 Typical High $1,230.27 | Professional | 50 · Both sides | $741.31 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $380.19 Typical High $512.86 | Professional | 62 · Two surgeons | $316.23 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $95.50 Typical High $128.82 | Professional | 80 · Assistant surgeon | $79.43 | $95.50 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $85.11 Typical High $114.82 | Professional | AS · PA/NP assist | $69.18 | $85.11 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $870.96 | Facility | None | $457.09 | $549.54 | $870.96 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $891.25 | Professional | None | $489.78 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $977.24 Typical High $3,801.89 | Facility | None | $34.67 | $977.24 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $3,630.78 | Professional | None | $562.34 | $1,096.48 | $3,630.78 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,202.26 | Professional | None | $660.69 | $891.25 | $1,202.26 |
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 $302.00 Median $331.13 Typical High $426.58 | Professional | 52 · Reduced service | $302.00 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $169.82 | Professional | 53 · Discontinued | $120.23 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $446.68 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $85.11 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $602.56 |
Where Kentucky 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.