How much rates vary
Facilitymedian $1,380 · 10th to 90th $525 to $3,020Professionalmedian $501 · 10th to 90th $389 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 $478.63 Median $588.84 Typical High $3,801.89 | Facility | None | $478.63 | $588.84 | $3,801.89 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $630.96 | Professional | None | $457.09 | $478.63 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $724.44 | Professional | None | $389.05 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $316.23 Typical High $457.09 | Professional | 62 · Two surgeons | $245.47 | $316.23 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $81.28 Typical High $114.82 | Professional | 80 · Assistant surgeon | $61.66 | $81.28 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $70.79 Typical High $100.00 | Professional | AS · PA/NP assist | $54.95 | $70.79 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $363.08 Median $691.83 Typical High $2,818.38 | Facility | None | $363.08 | $691.83 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $707.95 | Professional | None | $389.05 | $575.44 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,041.74 | Facility | None | $758.58 | $1,318.26 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $3,235.94 | Professional | None | $446.68 | $676.08 | $3,235.94 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $831.76 | Professional | None | $426.58 | $616.60 | $831.76 |
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 $229.09 Median $239.88 Typical High $309.03 | Professional | 52 · Reduced service | $229.09 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $91.20 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $338.84 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $93.33 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $47.86 Typical High $61.66 | Professional | 56 · Pre-op care only | $45.71 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $426.58 |
Where Kentucky sits
The same service costs 4.5 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 $6,608MT $1,483
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.