How much rates vary
Facilitymedian $2,630 · 10th to 90th $794 to $8,511Professionalmedian $776 · 10th to 90th $603 to $1,259
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 $741.31 Median $758.58 Typical High $2,630.27 | Facility | None | $741.31 | $758.58 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | None | $741.31 | $812.83 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $977.24 | Professional | None | $602.56 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $1,479.11 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $467.74 Typical High $616.60 | Professional | 62 · Two surgeons | $380.19 | $467.74 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $158.49 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $138.04 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $1,288.25 Typical High $7,585.78 | Facility | None | $794.33 | $1,288.25 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,348.96 | Professional | None | $812.83 | $1,096.48 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $4,466.84 | Facility | None | $1,412.54 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $3,981.07 | Professional | None | $741.31 | $1,047.13 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $407.38 | Professional | None | $33.11 | $33.11 | $407.38 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,513.56 | Professional | None | $758.58 | $977.24 | $1,513.56 |
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 $371.54 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $562.34 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $645.65 |
Where Kentucky sits
The same service costs 5.6 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 $14,385HI $2,567
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.