How much rates vary
Facilitymedian $4,467 · 10th to 90th $427 to $21,878Professionalmedian $1,122 · 10th to 90th $741 to $2,138
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 $831.76 Median $933.25 Typical High $2,187.76 | Professional | None | $831.76 | $933.25 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,513.56 Typical High $15,848.93 | Facility | None | $389.05 | $1,513.56 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,905.46 | Professional | None | $724.44 | $1,122.02 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $707.95 Typical High $1,230.27 | Professional | 62 · Two surgeons | $512.86 | $707.95 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $181.97 Typical High $316.23 | Professional | 80 · Assistant surgeon | $131.83 | $181.97 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $154.88 Typical High $281.84 | Professional | AS · PA/NP assist | $114.82 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $19,498.45 Typical High $24,547.09 | Facility | None | $398.11 | $19,498.45 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,290.87 | Professional | None | $933.25 | $1,288.25 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,949.84 | Professional | None | $741.31 | $933.25 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $8,709.64 Typical High $19,498.45 | Facility | None | $1,513.56 | $8,709.64 | $19,498.45 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $2,511.89 | Professional | None | $831.76 | $1,258.93 | $2,511.89 |
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 $407.38 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $691.83 |
Where Georgia sits
The same service costs 15.7 times more in Alaska 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
AK $30,778HI $1,955
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.