How much rates vary
Facilitymedian $2,951 · 10th to 90th $851 to $8,913Professionalmedian $813 · 10th to 90th $562 to $1,288
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 $676.08 Median $851.14 Typical High $3,235.94 | Facility | None | $676.08 | $851.14 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,380.38 | Professional | None | $616.60 | $741.31 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,096.48 | Professional | None | $562.34 | $707.95 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $446.68 Typical High $758.58 | Professional | 62 · Two surgeons | $354.81 | $446.68 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $114.82 Typical High $177.83 | Professional | 80 · Assistant surgeon | $89.13 | $114.82 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $100.00 Typical High $154.88 | Professional | AS · PA/NP assist | $79.43 | $100.00 | $154.88 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $977.24 Typical High $5,128.61 | Facility | None | $575.44 | $977.24 | $5,128.61 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,000.00 | Professional | None | $549.54 | $851.14 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $3,890.45 | Facility | None | $1,071.52 | $2,290.87 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,288.25 Typical High $4,466.84 | Professional | None | $630.96 | $1,288.25 | $4,466.84 |
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 $758.58 Median $1,023.29 Typical High $1,318.26 | Professional | None | $758.58 | $1,023.29 | $1,318.26 |
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 $331.13 Median $371.54 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $371.54 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $190.55 | Professional | 53 · Discontinued | $134.90 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $660.69 |
Where Kentucky 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.