How much rates vary
Facilitymedian $2,570 · 10th to 90th $661 to $8,511Professionalmedian $646 · 10th to 90th $513 to $1,023
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 $537.03 Median $660.69 Typical High $2,630.27 | Facility | None | $537.03 | $660.69 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $977.24 | Professional | None | $537.03 | $616.60 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,000.00 | Professional | None | $501.19 | $616.60 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $933.25 Typical High $1,513.56 | Professional | 50 · Both sides | $758.58 | $933.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $389.05 Typical High $630.96 | Professional | 62 · Two surgeons | $316.23 | $389.05 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $97.72 Typical High $162.18 | Professional | 80 · Assistant surgeon | $81.28 | $97.72 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $87.10 Typical High $141.25 | Professional | AS · PA/NP assist | $70.79 | $87.10 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $7,413.10 | Facility | None | $575.44 | $933.25 | $7,413.10 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $933.25 | Professional | None | $575.44 | $758.58 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $5,623.41 | Facility | None | $707.95 | $1,862.09 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $4,570.88 | Professional | None | $588.84 | $794.33 | $4,570.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $371.54 | Professional | None | $33.11 | $33.11 | $371.54 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,071.52 | Professional | None | $575.44 | $724.44 | $1,071.52 |
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 $269.15 Median $302.00 Typical High $398.11 | Professional | 52 · Reduced service | $269.15 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $123.03 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $588.84 | Professional | 54 · Surgery only | $398.11 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $117.49 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $53.70 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $426.58 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $371.54 | $426.58 | $549.54 |
Where Kentucky 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.