How much rates vary
Facilitymedian $1,445 · 10th to 90th $562 to $5,248Professionalmedian $1,096 · 10th to 90th $759 to $1,738
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 $912.01 Median $5,370.32 Typical High $10,000.00 | Facility | None | $912.01 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,096.48 | Professional | None | $891.25 | $954.99 | $1,096.48 |
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 $707.95 Median $1,096.48 Typical High $1,548.82 | Professional | None | $707.95 | $1,096.48 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,621.81 Typical High $2,238.72 | Professional | 50 · Both sides | $1,202.26 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $125.89 | $186.21 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $158.49 Typical High $229.09 | Professional | AS · PA/NP assist | $112.20 | $158.49 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,513.56 Typical High $2,570.40 | Facility | None | $616.60 | $1,513.56 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,089.30 | Professional | None | $758.58 | $1,288.25 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $4,265.80 | Professional | None | $794.33 | $912.01 | $4,265.80 |
Oscar Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,148.15 | $1,202.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,128.61 | Facility | None | $851.14 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,137.96 | Professional | None | $794.33 | $1,174.90 | $2,137.96 |
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 $446.68 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Where Georgia sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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 $7,181MS $1,948
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.