How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,148 to $10,471Professionalmedian $603 · 10th to 90th $468 to $1,413
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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $645.65 | Professional | None | $426.58 | $512.86 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $831.76 | Professional | None | $512.86 | $602.56 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $97.72 Typical High $131.83 | Professional | 80 · Assistant surgeon | $81.28 | $97.72 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $85.11 Typical High $114.82 | Professional | AS · PA/NP assist | $70.79 | $85.11 | $114.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $660.69 | Professional | None | $467.74 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $5,370.32 | Facility | None | $758.58 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $1,047.13 | Professional | None | $426.58 | $549.54 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,715.35 Typical High $26,302.68 | Facility | None | $724.44 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $3,715.35 | Professional | None | $512.86 | $851.14 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,000.00 | Professional | None | $446.68 | $645.65 | $1,000.00 |
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 $213.80 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $398.11 |
Where Missouri sits
The same service costs 7.5 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 $12,189MT $1,626
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.