How much rates vary
Facilitymedian $4,169 · 10th to 90th $708 to $10,715Professionalmedian $562 · 10th to 90th $89 to $977
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 $2,089.30 Median $7,244.36 Typical High $12,589.25 | Facility | None | $2,089.30 | $7,244.36 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $4,168.69 | Professional | None | $660.69 | $660.69 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $12,022.64 | Facility | None | $812.83 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,258.93 | Professional | None | $676.08 | $851.14 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $676.08 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $4,677.35 Typical High $6,165.95 | Facility | None | $831.76 | $4,677.35 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $7,244.36 | Facility | None | $602.56 | $4,466.84 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,258.93 | Professional | None | $660.69 | $851.14 | $1,258.93 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $7,079.46 | Facility | None | $602.56 | $4,466.84 | $7,079.46 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,288.25 | Professional | None | $676.08 | $851.14 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $416.87 Typical High $741.31 | Professional | None | $70.79 | $416.87 | $741.31 |
SummaCare Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,951.21 | Facility | None | $2,454.71 | $2,570.40 | $2,951.21 |
SummaCare Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $831.76 | Professional | None | $575.44 | $630.96 | $831.76 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $9,120.11 | Facility | None | $851.14 | $2,630.27 | $9,120.11 |
United Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,288.25 | Professional | None | $416.87 | $758.58 | $1,288.25 |
8 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 $331.13 Median $331.13 Typical High $1,258.93 | Professional | 52 · Reduced service | $331.13 | $331.13 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $501.19 | Professional | 53 · Discontinued | $131.83 | $131.83 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,862.09 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $371.54 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $251.19 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,258.93 Typical High $1,905.46 | Professional | 50 · Both sides | $1,023.29 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $117.49 Typical High $177.83 | Professional | AS · PA/NP assist | $95.50 | $117.49 | $177.83 |
Where Ohio 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.