How much rates vary
Facilitymedian $1,862 · 10th to 90th $631 to $6,166Professionalmedian $1,259 · 10th to 90th $813 to $2,042
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 $1,071.52 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,071.52 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,096.48 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,737.80 | Professional | None | $812.83 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,905.46 Typical High $2,630.27 | Professional | 50 · Both sides | $1,348.96 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $794.33 Typical High $1,096.48 | Professional | 62 · Two surgeons | $562.34 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $204.17 Typical High $281.84 | Professional | 80 · Assistant surgeon | $144.54 | $204.17 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $177.83 Typical High $245.47 | Professional | AS · PA/NP assist | $125.89 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,630.27 | Facility | None | $602.56 | $1,995.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,398.83 | Professional | None | $977.24 | $1,479.11 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $2,454.71 | Professional | None | $912.01 | $1,023.29 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,318.26 | $1,380.38 |
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 $851.14 Median $1,288.25 Typical High $2,454.71 | Professional | None | $851.14 | $1,288.25 | $2,454.71 |
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 $512.86 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $831.76 |
Where Georgia sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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
WI $8,254FL $2,626
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.