How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,072 to $12,303Professionalmedian $1,122 · 10th to 90th $794 to $1,820
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 $954.99 Median $1,230.27 Typical High $8,511.38 | Facility | None | $954.99 | $1,230.27 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,513.56 | Professional | None | $954.99 | $1,047.13 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $5,495.41 Typical High $14,454.40 | Facility | None | $1,995.26 | $5,495.41 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,479.11 | Professional | None | $794.33 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $660.69 Typical High $933.25 | Professional | 62 · Two surgeons | $501.19 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $165.96 Typical High $239.88 | Professional | 80 · Assistant surgeon | $128.82 | $165.96 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $112.20 | $147.91 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,380.38 Typical High $5,128.61 | Facility | None | $812.83 | $1,380.38 | $5,128.61 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,412.54 | Professional | None | $954.99 | $1,202.26 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $3,890.45 | Facility | None | $1,513.56 | $3,311.31 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,778.28 Typical High $6,456.54 | Professional | None | $891.25 | $1,778.28 | $6,456.54 |
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 $1,096.48 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,412.54 | $1,905.46 |
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 $478.63 Median $524.81 Typical High $676.08 | Professional | 52 · Reduced service | $478.63 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $269.15 | Professional | 53 · Discontinued | $190.55 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $707.95 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $199.53 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $134.90 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $933.25 |
Where Kentucky sits
The same service costs 4.0 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 $11,674MT $2,925
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.