How much rates vary
Facilitymedian $3,020 · 10th to 90th $851 to $8,710Professionalmedian $1,259 · 10th to 90th $832 to $2,399
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 $1,698.24 Median $7,079.46 Typical High $15,488.17 | Facility | None | $1,698.24 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $2,511.89 | Professional | None | $933.25 | $1,071.52 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $8,912.51 | Facility | None | $794.33 | $1,584.89 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,137.96 | Professional | None | $812.83 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,905.46 Typical High $3,311.31 | Professional | 50 · Both sides | $1,412.54 | $1,905.46 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $794.33 Typical High $1,412.54 | Professional | 62 · Two surgeons | $588.84 | $794.33 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $208.93 Typical High $363.08 | Professional | 80 · Assistant surgeon | $147.91 | $208.93 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $177.83 Typical High $316.23 | Professional | AS · PA/NP assist | $131.83 | $177.83 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $5,888.44 Typical High $7,762.47 | Facility | None | $831.76 | $5,888.44 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,445.44 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,137.96 | Professional | None | $831.76 | $1,047.13 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,818.38 | Professional | None | $954.99 | $1,412.54 | $2,818.38 |
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 $467.74 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $776.25 |
Where Georgia sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.