How much rates vary
Facilitymedian $2,818 · 10th to 90th $776 to $8,710Professionalmedian $1,148 · 10th to 90th $741 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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,318.26 | Professional | None | $851.14 | $851.14 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $10,964.78 | Facility | None | $707.95 | $1,584.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,862.09 | Professional | None | $707.95 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,778.28 Typical High $2,884.03 | Professional | 50 · Both sides | $1,230.27 | $1,778.28 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $758.58 Typical High $1,230.27 | Professional | 62 · Two surgeons | $524.81 | $758.58 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $5,370.32 | Facility | None | $741.31 | $4,073.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,187.76 | Professional | None | $954.99 | $1,318.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,698.24 | Professional | None | $870.96 | $977.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,230.27 Typical High $2,089.30 | Professional | None | $741.31 | $1,230.27 | $2,089.30 |
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 $416.87 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $660.69 |
Where Georgia sits
The same service costs 5.3 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 $14,031MT $2,637
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.