How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,096 to $10,471Professionalmedian $1,288 · 10th to 90th $1,047 to $1,950
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 $891.25 Median $1,348.96 Typical High $8,511.38 | Facility | None | $891.25 | $1,348.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $11,748.98 | Facility | None | $1,202.26 | $3,467.37 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $794.33 Typical High $1,071.52 | Professional | 62 · Two surgeons | $660.69 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $165.96 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $5,888.44 Median $7,585.78 Typical High $11,220.18 | Facility | None | $5,888.44 | $7,585.78 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $4,466.84 | Facility | None | $2,041.74 | $2,511.89 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $7,585.78 | Professional | None | $1,202.26 | $1,513.56 | $7,585.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,479.11 | $2,238.72 |
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 $549.54 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $218.78 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $1,000.00 |
Where Kentucky sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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 $14,661HI $3,664
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.