How much rates vary
Facilitymedian $1,585 · 10th to 90th $759 to $5,248Professionalmedian $832 · 10th to 90th $490 to $1,413
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 $467.74 Median $5,370.32 Typical High $9,549.93 | Facility | None | $467.74 | $5,370.32 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,513.56 | Professional | None | $467.74 | $616.60 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | None | $724.44 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $4,570.88 | Facility | None | $724.44 | $1,288.25 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,348.96 | Professional | None | $524.81 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $512.86 Typical High $870.96 | Professional | 62 · Two surgeons | $371.54 | $512.86 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $144.54 Typical High $234.42 | Professional | 80 · Assistant surgeon | $93.33 | $144.54 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $114.82 Typical High $199.53 | Professional | AS · PA/NP assist | $83.18 | $114.82 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $2,754.23 | Facility | None | $812.83 | $1,995.26 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,621.81 | Professional | None | $562.34 | $912.01 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,380.38 | Professional | None | $562.34 | $691.83 | $1,380.38 |
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 $537.03 Median $776.25 Typical High $1,348.96 | Professional | None | $537.03 | $776.25 | $1,348.96 |
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 $234.42 Median $234.42 Typical High $323.59 | Professional | 52 · Reduced service | $234.42 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 53 · Discontinued | $93.33 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $478.63 | Professional | 54 · Surgery only | $354.81 | $354.81 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $446.68 |
Where Georgia sits
The same service costs 3.6 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 $6,446MT $1,806
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.