How much rates vary
Facilitymedian $2,692 · 10th to 90th $631 to $8,710Professionalmedian $977 · 10th to 90th $661 to $1,778
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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,862.09 | Professional | None | $691.83 | $691.83 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $10,964.78 | Facility | None | $588.84 | $1,548.82 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,698.24 | Professional | None | $660.69 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,548.82 Typical High $2,570.40 | Professional | 50 · Both sides | $1,047.13 | $1,548.82 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $186.21 Typical High $288.40 | Professional | 80 · Assistant surgeon | $109.65 | $186.21 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $147.91 Typical High $239.88 | Professional | AS · PA/NP assist | $97.72 | $147.91 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,248.07 Typical High $6,606.93 | Facility | None | $602.56 | $5,248.07 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $776.25 | $1,122.02 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,659.59 | Professional | None | $707.95 | $794.33 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $645.65 Median $1,122.02 Typical High $1,819.70 | Professional | None | $645.65 | $1,122.02 | $1,819.70 |
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 $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $537.03 |
Where Georgia sits
The same service costs 6.4 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 $13,837MT $2,168
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.