How much rates vary
Facilitymedian $1,585 · 10th to 90th $562 to $5,248Professionalmedian $1,660 · 10th to 90th $977 to $2,818
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 $977.24 Median $5,370.32 Typical High $10,000.00 | Facility | None | $977.24 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,348.96 | Professional | None | $954.99 | $1,230.27 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,659.59 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,071.52 Typical High $1,778.28 | Professional | 62 · Two surgeons | $758.58 | $1,071.52 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $295.12 Typical High $467.74 | Professional | 80 · Assistant surgeon | $190.55 | $295.12 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $239.88 Typical High $398.11 | Professional | AS · PA/NP assist | $169.82 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $3,467.37 | Facility | None | $602.56 | $2,691.53 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,202.26 | $1,905.46 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,288.25 | $1,819.70 |
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 $1,174.90 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,737.80 | $2,754.23 |
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 $478.63 Median $478.63 Typical High $645.65 | Professional | 52 · Reduced service | $478.63 | $478.63 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | 53 · Discontinued | $190.55 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $977.24 | Professional | 54 · Surgery only | $724.44 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $912.01 |
Where Georgia sits
The same service costs 4.4 times more in Alaska 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
AK $10,675KY $2,405
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.