How much rates vary
Facilitymedian $3,090 · 10th to 90th $724 to $7,762Professionalmedian $1,349 · 10th to 90th $912 to $2,399
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 $1,071.52 Median $6,309.57 Typical High $10,000.00 | Facility | None | $1,071.52 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,096.48 | $2,818.38 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $851.14 Median $1,318.26 Typical High $2,137.96 | Professional | None | $851.14 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,187.76 Typical High $3,235.94 | Professional | 50 · Both sides | $1,513.56 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $933.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $630.96 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $158.49 | $257.04 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $204.17 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $204.17 | $302.00 |
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 $1,096.48 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,995.26 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $2,884.03 | Professional | None | $954.99 | $1,122.02 | $2,884.03 |
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 $977.24 Median $1,548.82 Typical High $3,162.28 | Professional | None | $977.24 | $1,548.82 | $3,162.28 |
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 $512.86 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $512.86 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $776.25 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $891.25 |
Where Georgia sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $11,128KY $2,365
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.