How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,413Professionalmedian $2,455 · 10th to 90th $1,585 to $4,074
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 $1,995.26 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,995.26 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $2,290.87 | Professional | None | $1,949.84 | $1,995.26 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $9,772.37 | Facility | None | $707.95 | $2,041.74 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,548.82 | $2,454.71 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,698.24 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,148.15 | $1,698.24 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $467.74 Typical High $645.65 | Professional | 80 · Assistant surgeon | $281.84 | $467.74 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $371.54 Typical High $549.54 | Professional | AS · PA/NP assist | $257.04 | $371.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $5,623.41 | Professional | None | $1,949.84 | $2,754.23 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,737.80 | $2,041.74 | $2,818.38 |
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 $1,862.09 Median $2,884.03 Typical High $5,754.40 | Professional | None | $1,862.09 | $2,884.03 | $5,754.40 |
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 $977.24 Median $1,000.00 Typical High $1,096.48 | Professional | 52 · Reduced service | $977.24 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $446.68 | Professional | 53 · Discontinued | $389.05 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,479.11 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,479.11 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $302.00 Typical High $331.13 | Professional | 55 · Aftercare only | $288.40 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $199.53 Typical High $218.78 | Professional | 56 · Pre-op care only | $194.98 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,380.38 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,380.38 | $1,548.82 |
Where Georgia sits
The same service costs 8.3 times more in Alabama 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
AL $19,381WA $2,326
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.