How much rates vary
Facilitymedian $3,981 · 10th to 90th $832 to $14,791Professionalmedian $550 · 10th to 90th $437 to $794
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 $549.54 Median $691.83 Typical High $5,495.41 | Facility | None | $549.54 | $691.83 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $707.95 | Professional | None | $549.54 | $562.34 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,089.30 | $5,754.40 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $741.31 | Professional | None | $436.52 | $524.81 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $794.33 Typical High $1,096.48 | Professional | 50 · Both sides | $660.69 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $331.13 Typical High $457.09 | Professional | 62 · Two surgeons | $275.42 | $331.13 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $85.11 Typical High $117.49 | Professional | 80 · Assistant surgeon | $69.18 | $85.11 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $74.13 Typical High $102.33 | Professional | AS · PA/NP assist | $61.66 | $74.13 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $831.76 Typical High $4,786.30 | Facility | None | $501.19 | $831.76 | $4,786.30 |
CareSource Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $831.76 | Professional | None | $467.74 | $660.69 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $4,168.69 | Facility | None | $954.99 | $3,467.37 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $3,090.30 | Professional | None | $537.03 | $616.60 | $3,090.30 |
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 $512.86 Median $676.08 Typical High $851.14 | Professional | None | $512.86 | $676.08 | $851.14 |
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 $275.42 Median $281.84 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $489.78 |
Where Kentucky 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.