How much rates vary
Facilitymedian $1,995 · 10th to 90th $617 to $6,310Professionalmedian $1,862 · 10th to 90th $1,259 to $3,236
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 $1,513.56 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,513.56 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,513.56 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,862.09 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,288.25 Typical High $1,905.46 | Professional | 62 · Two surgeons | $870.96 | $1,288.25 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $331.13 Typical High $512.86 | Professional | 80 · Assistant surgeon | $213.80 | $331.13 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $281.84 Typical High $426.58 | Professional | AS · PA/NP assist | $194.98 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $4,570.88 | Facility | None | $602.56 | $3,630.78 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,479.11 | $2,238.72 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,584.89 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,511.89 | $2,570.40 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $4,466.84 | Professional | None | $1,380.38 | $2,041.74 | $4,466.84 |
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 $724.44 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $724.44 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $323.59 | Professional | 53 · Discontinued | $288.40 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $162.18 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,148.15 |
Where Georgia sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.