How much rates vary
Facilitymedian $2,884 · 10th to 90th $871 to $10,233Professionalmedian $851 · 10th to 90th $676 to $1,380
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 $691.83 Median $870.96 Typical High $3,630.78 | Facility | None | $691.83 | $870.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,174.90 | Professional | None | $691.83 | $794.33 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $489.78 | Professional | None | $66.07 | $66.07 | $489.78 |
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 $676.08 Median $831.76 Typical High $1,380.38 | Professional | None | $676.08 | $831.76 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,258.93 Typical High $2,041.74 | Professional | 50 · Both sides | $1,000.00 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $524.81 Typical High $870.96 | Professional | 62 · Two surgeons | $426.58 | $524.81 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $131.83 Typical High $218.78 | Professional | 80 · Assistant surgeon | $107.15 | $131.83 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $165.96 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $5,888.44 | Facility | None | $741.31 | $1,202.26 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,258.93 | Professional | None | $831.76 | $1,023.29 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $4,466.84 | Facility | None | $1,318.26 | $2,511.89 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $6,025.60 | Professional | None | $776.25 | $1,071.52 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $537.03 | Professional | None | $33.11 | $33.11 | $537.03 |
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 $776.25 Median $954.99 Typical High $1,445.44 | Professional | None | $776.25 | $954.99 | $1,445.44 |
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 $346.74 Median $398.11 Typical High $512.86 | Professional | 52 · Reduced service | $346.74 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $204.17 | Professional | 53 · Discontinued | $141.25 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $776.25 | Professional | 54 · Surgery only | $524.81 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $104.71 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $102.33 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $724.44 |
Where Kentucky sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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 $14,031WV $2,390
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.