How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,202 to $10,471Professionalmedian $851 · 10th to 90th $631 to $1,905
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,047.13 | Professional | None | $575.44 | $691.83 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $6,606.93 | Facility | None | $1,288.25 | $3,467.37 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,230.27 | Professional | None | $707.95 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,819.70 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $194.98 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $169.82 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $891.25 | Professional | None | $630.96 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,677.35 Typical High $6,918.31 | Facility | None | $645.65 | $4,677.35 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,412.54 | Professional | None | $562.34 | $724.44 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $4,073.80 Typical High $27,542.29 | Facility | None | $1,000.00 | $4,073.80 | $27,542.29 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $5,754.40 | Professional | None | $691.83 | $1,202.26 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,348.96 | Professional | None | $602.56 | $870.96 | $1,348.96 |
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 $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $524.81 |
Where Missouri 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.