How much rates vary
Facilitymedian $912 · 10th to 90th $501 to $6,166Professionalmedian $3,631 · 10th to 90th $2,512 to $6,310
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 $2,818.38 Median $2,884.03 Typical High $4,570.88 | Professional | None | $2,818.38 | $2,884.03 | $4,570.88 |
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 $2,344.23 Median $3,630.78 Typical High $6,025.60 | Professional | None | $2,344.23 | $3,630.78 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,073.80 Median $6,165.95 Typical High $8,912.51 | Professional | 50 · Both sides | $4,073.80 | $6,165.95 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,570.40 Typical High $3,801.89 | Professional | 62 · Two surgeons | $1,737.80 | $2,570.40 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $724.44 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $436.52 | $724.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $575.44 Typical High $851.14 | Professional | AS · PA/NP assist | $380.19 | $575.44 | $851.14 |
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 $3,019.95 Median $4,365.16 Typical High $8,709.64 | Professional | None | $3,019.95 | $4,365.16 | $8,709.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $5,888.44 | Professional | None | $2,630.27 | $2,884.03 | $5,888.44 |
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 $2,754.23 Median $4,265.80 Typical High $8,912.51 | Professional | None | $2,754.23 | $4,265.80 | $8,912.51 |
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 $1,412.54 Median $1,445.44 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | 53 · Discontinued | $562.34 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,187.76 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,137.96 | $2,187.76 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $524.81 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $288.40 Typical High $346.74 | Professional | 56 · Pre-op care only | $281.84 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,041.74 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,041.74 | $2,454.71 |
Where Georgia sits
The same service costs 7.3 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 $22,256WA $3,065
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.