How much rates vary
Facilitymedian $1,318 · 10th to 90th $692 to $5,129Professionalmedian $407 · 10th to 90th $288 to $759
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 $295.12 Median $5,370.32 Typical High $8,317.64 | Facility | None | $295.12 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $794.33 | Professional | None | $295.12 | $338.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $645.65 | Professional | None | $288.40 | $407.38 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $186.21 Median $257.04 Typical High $416.87 | Professional | 62 · Two surgeons | $186.21 | $257.04 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $66.07 Typical High $107.15 | Professional | 80 · Assistant surgeon | $46.77 | $66.07 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $57.54 Typical High $97.72 | Professional | AS · PA/NP assist | $40.74 | $57.54 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,584.89 | Facility | None | $741.31 | $1,202.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $812.83 | Professional | None | $331.13 | $457.09 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $954.99 | Professional | None | $281.84 | $346.74 | $954.99 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $912.01 | Professional | None | $302.00 | $457.09 | $912.01 |
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 $147.91 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $208.93 | $245.47 |
Where Georgia sits
The same service costs 6.6 times more in Oklahoma 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
OK $6,126MT $925
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.