How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,349 to $10,715Professionalmedian $1,549 · 10th to 90th $1,175 to $3,631
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,288.25 | $1,995.26 |
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 $1,288.25 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,513.56 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,318.26 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,258.93 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,801.89 Typical High $5,370.32 | Facility | None | $912.01 | $3,801.89 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,380.38 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,412.54 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $9,549.93 | Professional | None | $1,288.25 | $2,137.96 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,621.81 | $2,570.40 |
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 $537.03 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $537.03 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $218.78 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $1,000.00 |
Where Missouri 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.