How much rates vary
Facilitymedian $2,951 · 10th to 90th $676 to $12,882Professionalmedian $832 · 10th to 90th $631 to $1,995
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 $1,023.29 Median $4,677.35 Typical High $7,762.47 | Facility | None | $1,023.29 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,047.13 | Professional | None | $575.44 | $676.08 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,122.02 | Professional | None | $676.08 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,258.93 Typical High $1,659.59 | Professional | 50 · Both sides | $1,023.29 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $537.03 Typical High $707.95 | Professional | 62 · Two surgeons | $426.58 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $134.90 Typical High $177.83 | Professional | 80 · Assistant surgeon | $107.15 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $117.49 Typical High $154.88 | Professional | AS · PA/NP assist | $95.50 | $117.49 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $891.25 | Professional | None | $630.96 | $676.08 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,570.88 Typical High $6,760.83 | Facility | None | $645.65 | $4,570.88 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,380.38 | Professional | None | $562.34 | $724.44 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,011.87 Typical High $26,302.68 | Facility | None | $912.01 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $5,011.87 | Professional | None | $676.08 | $1,122.02 | $5,011.87 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,348.96 | Professional | None | $588.84 | $831.76 | $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 $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $338.84 | $371.54 |
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 $85.11 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $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 $13,816MT $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.