How much rates vary
Facilitymedian $1,820 · 10th to 90th $427 to $7,079Professionalmedian $1,096 · 10th to 90th $692 to $1,862
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 $831.76 Median $3,548.13 Typical High $7,585.78 | Facility | None | $831.76 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,288.25 | Professional | None | $794.33 | $794.33 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,122.02 Typical High $7,244.36 | Facility | None | $389.05 | $1,122.02 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,737.80 | Professional | None | $645.65 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $173.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $117.49 | $173.78 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $107.15 | $151.36 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $3,019.95 Typical High $3,801.89 | Facility | None | $398.11 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,187.76 | Professional | None | $870.96 | $1,202.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,479.11 | Professional | None | $724.44 | $912.01 | $1,479.11 |
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 $794.33 Median $1,148.15 Typical High $2,454.71 | Professional | None | $794.33 | $1,148.15 | $2,454.71 |
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 $398.11 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Where Georgia sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.