How much rates vary
Facilitymedian $2,455 · 10th to 90th $708 to $8,318Professionalmedian $724 · 10th to 90th $562 to $1,230
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 $575.44 Median $707.95 Typical High $2,630.27 | Facility | None | $575.44 | $707.95 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,096.48 | Professional | None | $575.44 | $660.69 | $1,096.48 |
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 $549.54 Median $724.44 Typical High $1,230.27 | Professional | None | $549.54 | $724.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,071.52 Typical High $1,819.70 | Professional | 50 · Both sides | $812.83 | $1,071.52 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $114.82 Typical High $194.98 | Professional | 80 · Assistant surgeon | $87.10 | $114.82 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $100.00 Typical High $169.82 | Professional | AS · PA/NP assist | $75.86 | $100.00 | $169.82 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $1,000.00 Typical High $8,128.31 | Facility | None | $616.60 | $1,000.00 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,023.29 | Professional | None | $616.60 | $851.14 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $5,754.40 | Facility | None | $1,096.48 | $1,862.09 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $6,025.60 | Professional | None | $645.65 | $912.01 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $371.54 | Professional | None | $33.11 | $33.11 | $371.54 |
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 $676.08 Median $812.83 Typical High $1,202.26 | Professional | None | $676.08 | $812.83 | $1,202.26 |
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 $288.40 Median $331.13 Typical High $426.58 | Professional | 52 · Reduced service | $288.40 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $169.82 | Professional | 53 · Discontinued | $114.82 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $128.82 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $85.11 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $602.56 |
Where Kentucky 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.