How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,175 to $10,000Professionalmedian $1,585 · 10th to 90th $1,047 to $2,884
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 $1,202.26 Median $5,370.32 Typical High $10,000.00 | Facility | None | $1,202.26 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,202.26 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $11,220.18 | Facility | None | $1,071.52 | $1,995.26 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,511.89 Typical High $4,073.80 | Professional | 50 · Both sides | $1,698.24 | $2,511.89 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | 62 · Two surgeons | $724.44 | $1,071.52 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $288.40 Typical High $457.09 | Professional | 80 · Assistant surgeon | $181.97 | $288.40 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $239.88 Typical High $380.19 | Professional | AS · PA/NP assist | $158.49 | $239.88 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $6,309.57 | Facility | None | $1,513.56 | $4,265.80 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,905.46 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,479.11 | $3,090.30 |
Oscar Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,801.89 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,000.00 | $1,698.24 | $3,162.28 |
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 $588.84 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $977.24 |
Where Georgia sits
The same service costs 5.0 times more in Colorado 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
CO $14,731KY $2,968
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.