How much rates vary
Facilitymedian $1,698 · 10th to 90th $871 to $5,248Professionalmedian $933 · 10th to 90th $550 to $1,660
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 $707.95 Median $6,760.83 Typical High $10,964.78 | Facility | None | $707.95 | $6,760.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,778.28 | Professional | None | $537.03 | $707.95 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,621.81 Typical High $4,677.35 | Facility | None | $794.33 | $1,621.81 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,548.82 | Professional | None | $602.56 | $933.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $588.84 Typical High $1,023.29 | Professional | 62 · Two surgeons | $416.87 | $588.84 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $162.18 Typical High $275.42 | Professional | 80 · Assistant surgeon | $107.15 | $162.18 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $131.83 Typical High $229.09 | Professional | AS · PA/NP assist | $93.33 | $131.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,122.02 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,862.09 | Professional | None | $676.08 | $1,071.52 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,584.89 | Professional | None | $645.65 | $758.58 | $1,584.89 |
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 $630.96 Median $891.25 Typical High $1,548.82 | Professional | None | $630.96 | $891.25 | $1,548.82 |
7 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 $269.15 Median $269.15 Typical High $371.54 | Professional | 52 · Reduced service | $269.15 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $147.91 | Professional | 53 · Discontinued | $107.15 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $407.38 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $512.86 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 59 · Distinct service | $1,174.90 | $1,174.90 | $1,174.90 |
Where Georgia sits
The same service costs 4.5 times more in Alabama than in West Virginia. 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
AL $9,026WV $2,015
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.