How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,259 to $13,183Professionalmedian $1,047 · 10th to 90th $776 to $2,570
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 $933.25 Median $5,623.41 Typical High $10,715.19 | Facility | None | $933.25 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,698.24 | Professional | None | $691.83 | $831.76 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,479.11 | $3,981.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,412.54 | Professional | None | $831.76 | $1,071.52 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,621.81 Typical High $2,089.30 | Professional | 50 · Both sides | $1,258.93 | $1,621.81 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $676.08 Typical High $891.25 | Professional | 62 · Two surgeons | $524.81 | $676.08 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $223.87 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $151.36 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $151.36 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,096.48 | Professional | None | $758.58 | $812.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $12,882.50 | Facility | None | $1,548.82 | $4,073.80 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,698.24 | Professional | None | $691.83 | $891.25 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $4,466.84 Typical High $26,302.68 | Facility | None | $1,122.02 | $4,466.84 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,412.54 Typical High $6,025.60 | Professional | None | $831.76 | $1,412.54 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $4,168.69 Typical High $12,022.64 | Facility | None | $1,513.56 | $4,168.69 | $12,022.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,621.81 | Professional | None | $724.44 | $1,047.13 | $1,621.81 |
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 $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $645.65 |
Where Missouri 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.