How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,023 to $10,715Professionalmedian $1,096 · 10th to 90th $871 to $1,698
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 $912.01 Median $1,122.02 Typical High $8,511.38 | Facility | None | $912.01 | $1,122.02 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,348.96 | Professional | None | $912.01 | $1,047.13 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,659.59 | Professional | None | $870.96 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,621.81 Typical High $2,511.89 | Professional | 50 · Both sides | $1,288.25 | $1,621.81 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $691.83 Typical High $1,047.13 | Professional | 62 · Two surgeons | $549.54 | $691.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $173.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $138.04 | $173.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $151.36 Typical High $234.42 | Professional | AS · PA/NP assist | $120.23 | $151.36 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,584.89 Typical High $5,888.44 | Facility | None | $954.99 | $1,584.89 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,621.81 | Professional | None | $891.25 | $1,318.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $3,090.30 Typical High $4,466.84 | Facility | None | $1,698.24 | $3,090.30 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $7,079.46 | Professional | None | $1,000.00 | $1,318.26 | $7,079.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $691.83 | Professional | None | $33.11 | $33.11 | $691.83 |
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 $1,023.29 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,258.93 | $1,862.09 |
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 $457.09 Median $512.86 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $208.93 Typical High $269.15 | Professional | 53 · Discontinued | $181.97 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $676.08 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $154.88 Typical High $199.53 | Professional | 55 · Aftercare only | $134.90 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $104.71 Typical High $134.90 | Professional | 56 · Pre-op care only | $91.20 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $933.25 |
Where Kentucky sits
The same service costs 4.2 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 $14,362MT $3,396
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.