How much rates vary
Facilitymedian $2,291 · 10th to 90th $490 to $8,318Professionalmedian $417 · 10th to 90th $347 to $661
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 $363.08 Median $457.09 Typical High $2,630.27 | Facility | None | $363.08 | $457.09 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $489.78 | Professional | None | $363.08 | $407.38 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $602.56 | Professional | None | $346.74 | $407.38 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $66.07 Typical High $97.72 | Professional | 80 · Assistant surgeon | $54.95 | $66.07 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $56.23 Typical High $85.11 | Professional | AS · PA/NP assist | $47.86 | $56.23 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $630.96 Typical High $5,888.44 | Facility | None | $338.84 | $630.96 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $660.69 | Professional | None | $389.05 | $537.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $4,466.84 | Facility | None | $602.56 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $2,570.40 | Professional | None | $398.11 | $501.19 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $257.04 | Professional | None | $33.11 | $33.11 | $257.04 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $741.31 | Professional | None | $389.05 | $478.63 | $741.31 |
7 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 $181.97 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $72.44 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $275.42 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $338.84 |
Ambetter Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 82 · Assistant surgeon, no resident | $41.69 | $41.69 | $41.69 |
Where Kentucky sits
The same service costs 8.5 times more in Colorado than in Montana. 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 $11,809MT $1,385
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.