How much rates vary
Facilitymedian $1,820 · 10th to 90th $562 to $6,026Professionalmedian $1,047 · 10th to 90th $676 to $1,820
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 $602.56 Median $5,623.41 Typical High $9,549.93 | Facility | None | $602.56 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,949.84 | Professional | None | $602.56 | $794.33 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,677.35 | Facility | None | $512.86 | $1,000.00 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,698.24 | Professional | None | $676.08 | $1,047.13 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $660.69 Typical High $1,122.02 | Professional | 62 · Two surgeons | $467.74 | $660.69 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $186.21 Typical High $309.03 | Professional | 80 · Assistant surgeon | $117.49 | $186.21 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $147.91 Typical High $251.19 | Professional | AS · PA/NP assist | $104.71 | $147.91 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $2,041.74 | Professional | None | $724.44 | $1,148.15 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $2,630.27 | Professional | None | $676.08 | $831.76 | $2,630.27 |
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 $691.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $691.83 | $1,023.29 | $1,778.28 |
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 $302.00 Median $302.00 Typical High $407.38 | Professional | 52 · Reduced service | $302.00 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $575.44 |
Where Georgia sits
The same service costs 4.2 times more in Oklahoma than in Kentucky. 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 $7,810KY $1,873
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.