How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,047 to $9,120Professionalmedian $794 · 10th to 90th $537 to $1,479
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 $588.84 Median $7,413.10 Typical High $15,488.17 | Facility | None | $588.84 | $7,413.10 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,548.82 | Professional | None | $562.34 | $616.60 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,096.48 | Professional | None | $812.83 | $1,096.48 | $1,096.48 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | 50 · Both sides | $1,148.15 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $8,511.38 | Facility | None | $1,023.29 | $1,778.28 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,288.25 | Professional | None | $467.74 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,258.93 Typical High $2,137.96 | Professional | 50 · Both sides | $891.25 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $524.81 Typical High $912.01 | Professional | 62 · Two surgeons | $380.19 | $524.81 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $144.54 Typical High $239.88 | Professional | 80 · Assistant surgeon | $95.50 | $144.54 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $114.82 Typical High $208.93 | Professional | AS · PA/NP assist | $83.18 | $114.82 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,630.78 Typical High $5,248.07 | Facility | None | $1,122.02 | $3,630.78 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,584.89 | Professional | None | $602.56 | $954.99 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,513.56 | Professional | None | $660.69 | $758.58 | $1,513.56 |
Oscar Health Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,348.96 | Professional | None | $602.56 | $1,047.13 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $524.81 Median $912.01 Typical High $1,819.70 | Professional | None | $524.81 | $912.01 | $1,819.70 |
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 $281.84 Median $281.84 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $512.86 |
Where Georgia sits
The same service costs 6.0 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 $11,096MT $1,846
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.