How much rates vary
Facilitymedian $2,138 · 10th to 90th $741 to $7,586Professionalmedian $891 · 10th to 90th $589 to $1,514
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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,445.44 | Professional | None | $645.65 | $645.65 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $1,000.00 Typical High $1,000.00 | Professional | None | $251.19 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $8,511.38 | Facility | None | $691.83 | $1,412.54 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,412.54 | Professional | None | $575.44 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $549.54 Typical High $912.01 | Professional | 62 · Two surgeons | $407.38 | $549.54 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $141.25 Typical High $245.47 | Professional | 80 · Assistant surgeon | $102.33 | $141.25 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $123.03 Typical High $204.17 | Professional | AS · PA/NP assist | $89.13 | $123.03 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,778.28 | Professional | None | $724.44 | $977.24 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,202.26 | Professional | None | $588.84 | $741.31 | $1,202.26 |
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 $660.69 Median $977.24 Typical High $1,995.26 | Professional | None | $660.69 | $977.24 | $1,995.26 |
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 $323.59 Median $323.59 Typical High $389.05 | Professional | 52 · Reduced service | $323.59 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $549.54 |
Where Georgia sits
The same service costs 5.1 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 $10,170MT $2,000
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.