How much rates vary
Facilitymedian $3,162 · 10th to 90th $631 to $9,333Professionalmedian $955 · 10th to 90th $617 to $1,622
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 $741.31 Typical High $1,819.70 | Professional | None | $691.83 | $741.31 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $912.01 | Professional | None | $426.58 | $616.60 | $912.01 |
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 $616.60 Median $954.99 Typical High $1,548.82 | Professional | None | $616.60 | $954.99 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,479.11 Typical High $2,344.23 | Professional | 50 · Both sides | $1,023.29 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $616.60 Typical High $977.24 | Professional | 62 · Two surgeons | $426.58 | $616.60 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $181.97 Typical High $263.03 | Professional | 80 · Assistant surgeon | $107.15 | $181.97 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $138.04 Typical High $213.80 | Professional | AS · PA/NP assist | $95.50 | $138.04 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,128.61 Typical High $6,456.54 | Facility | None | $602.56 | $5,128.61 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,778.28 | Professional | None | $776.25 | $1,071.52 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,659.59 | Professional | None | $724.44 | $794.33 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,174.90 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,698.24 | Professional | None | $616.60 | $1,000.00 | $1,698.24 |
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 $338.84 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $346.74 | $380.19 |
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 $512.86 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $114.82 |
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 $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $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 $13,816MT $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.