How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,148 to $12,882Professionalmedian $776 · 10th to 90th $589 to $1,950
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 $1,258.93 Median $4,677.35 Typical High $7,762.47 | Facility | None | $1,258.93 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,230.27 | Professional | None | $537.03 | $645.65 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,202.26 Typical High $1,659.59 | Professional | 50 · Both sides | $933.25 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $512.86 Typical High $691.83 | Professional | 62 · Two surgeons | $398.11 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $177.83 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $112.20 Typical High $154.88 | Professional | AS · PA/NP assist | $87.10 | $112.20 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $831.76 | Professional | None | $588.84 | $630.96 | $831.76 |
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 $524.81 Median $676.08 Typical High $1,288.25 | Professional | None | $524.81 | $676.08 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $5,011.87 Typical High $26,302.68 | Facility | None | $851.14 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $4,677.35 | Professional | None | $630.96 | $1,071.52 | $4,677.35 |
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 $549.54 Median $776.25 Typical High $1,258.93 | Professional | None | $549.54 | $776.25 | $1,258.93 |
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 $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $398.11 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $489.78 |
Where Missouri 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.