How much rates vary
Facilitymedian $2,042 · 10th to 90th $617 to $7,244Professionalmedian $794 · 10th to 90th $501 to $1,380
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 $5,370.32 Typical High $10,000.00 | Facility | None | $602.56 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,445.44 | Professional | None | $457.09 | $575.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $7,244.36 | Facility | None | $588.84 | $1,230.27 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,318.26 | Professional | None | $501.19 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $501.19 Typical High $851.14 | Professional | 62 · Two surgeons | $354.81 | $501.19 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $144.54 Typical High $223.87 | Professional | 80 · Assistant surgeon | $91.20 | $144.54 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $120.23 Typical High $194.98 | Professional | AS · PA/NP assist | $79.43 | $120.23 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,630.27 Typical High $3,311.31 | Facility | None | $602.56 | $2,630.27 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $1,548.82 | Professional | None | $562.34 | $912.01 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,288.25 | Professional | None | $512.86 | $616.60 | $1,288.25 |
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 $549.54 Median $794.33 Typical High $1,288.25 | Professional | None | $549.54 | $794.33 | $1,288.25 |
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 $229.09 Median $229.09 Typical High $316.23 | Professional | 52 · Reduced service | $229.09 | $229.09 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $91.20 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $338.84 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $93.33 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $436.52 |
Where Georgia sits
The same service costs 5.6 times more in Alabama 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
AL $8,949KY $1,586
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.