How much rates vary
Facilitymedian $2,512 · 10th to 90th $562 to $7,413Professionalmedian $1,202 · 10th to 90th $813 to $2,239
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 $954.99 Median $5,011.87 Typical High $7,943.28 | Facility | None | $954.99 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $2,290.87 | Professional | None | $870.96 | $933.25 | $2,290.87 |
Ambetter Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,089.30 | Professional | None | $794.33 | $1,202.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $776.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $537.03 | $776.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $218.78 Typical High $371.54 | Professional | 80 · Assistant surgeon | $138.04 | $218.78 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $169.82 Typical High $295.12 | Professional | AS · PA/NP assist | $120.23 | $169.82 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,570.88 Typical High $5,888.44 | Facility | None | $524.81 | $4,570.88 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $2,570.40 | Professional | None | $977.24 | $1,412.54 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,884.03 | Professional | None | $870.96 | $1,071.52 | $2,884.03 |
Oscar Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,630.27 | Professional | None | $831.76 | $1,202.26 | $2,630.27 |
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 $426.58 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | 54 · Surgery only | $645.65 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $707.95 |
Where Georgia sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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 $10,712HI $2,282
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.