How much rates vary
Facilitymedian $2,951 · 10th to 90th $741 to $7,762Professionalmedian $1,023 · 10th to 90th $692 to $1,660
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 $741.31 Median $5,370.32 Typical High $8,317.64 | Facility | None | $741.31 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,949.84 | Professional | None | $724.44 | $776.25 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $1,174.90 Typical High $1,479.11 | Professional | None | $602.56 | $1,174.90 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,548.82 | Professional | None | $691.83 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $707.95 Typical High $1,000.00 | Professional | 62 · Two surgeons | $446.68 | $707.95 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $112.20 | $186.21 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $158.49 Typical High $223.87 | Professional | AS · PA/NP assist | $97.72 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $5,370.32 | Facility | None | $741.31 | $3,715.35 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,995.26 | Professional | None | $776.25 | $1,318.26 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $2,041.74 | Professional | None | $691.83 | $794.33 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $1,230.27 Typical High $1,548.82 | Professional | None | $691.83 | $1,230.27 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,715.35 | $9,120.11 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $2,238.72 | Professional | None | $691.83 | $1,096.48 | $2,238.72 |
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 $363.08 Median $371.54 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $630.96 |
Where Georgia sits
The same service costs 5.3 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 $10,556MT $2,002
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.