How much rates vary
Facilitymedian $813 · 10th to 90th $490 to $4,898Professionalmedian $1,549 · 10th to 90th $1,072 to $2,692
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 $1,230.27 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,230.27 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $5,495.41 | Facility | None | $524.81 | $1,096.48 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,548.82 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,096.48 Typical High $1,584.89 | Professional | 62 · Two surgeons | $724.44 | $1,096.48 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $288.40 Typical High $426.58 | Professional | 80 · Assistant surgeon | $181.97 | $288.40 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $239.88 Typical High $354.81 | Professional | AS · PA/NP assist | $162.18 | $239.88 | $354.81 |
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 $1,288.25 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,862.09 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,380.38 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,238.72 | Professional | None | $1,905.46 | $2,187.76 | $2,238.72 |
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 $1,148.15 Median $1,737.80 Typical High $3,801.89 | Professional | None | $1,148.15 | $1,737.80 | $3,801.89 |
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 $602.56 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,047.13 |
Where Georgia sits
The same service costs 9.9 times more in Alabama than in Maryland. 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 $18,241MD $1,851
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.