How much rates vary
Facilitymedian $3,162 · 10th to 90th $631 to $9,333Professionalmedian $891 · 10th to 90th $575 to $1,514
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 $630.96 Median $691.83 Typical High $1,698.24 | Professional | None | $630.96 | $691.83 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $645.65 Typical High $794.33 | Professional | None | $107.15 | $645.65 | $794.33 |
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 $575.44 Median $891.25 Typical High $1,445.44 | Professional | None | $575.44 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,380.38 Typical High $2,187.76 | Professional | 50 · Both sides | $954.99 | $1,380.38 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $575.44 Typical High $933.25 | Professional | 62 · Two surgeons | $398.11 | $575.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $100.00 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $128.82 Typical High $204.17 | Professional | AS · PA/NP assist | $89.13 | $128.82 | $204.17 |
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 $707.95 Median $1,000.00 Typical High $1,659.59 | Professional | None | $707.95 | $1,000.00 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,548.82 | Professional | None | $676.08 | $741.31 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,122.02 | Professional | None | $977.24 | $1,096.48 | $1,122.02 |
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 $588.84 Median $977.24 Typical High $1,584.89 | Professional | None | $588.84 | $977.24 | $1,584.89 |
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 $316.23 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $501.19 |
Where Georgia sits
The same service costs 6.8 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 $13,753MT $2,023
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.