How much rates vary
Facilitymedian $2,951 · 10th to 90th $794 to $8,913Professionalmedian $741 · 10th to 90th $603 to $1,175
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 $630.96 Median $776.25 Typical High $8,511.38 | Facility | None | $630.96 | $776.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $933.25 | Professional | None | $630.96 | $707.95 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,148.15 | Professional | None | $602.56 | $741.31 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,122.02 Typical High $1,698.24 | Professional | 50 · Both sides | $891.25 | $1,122.02 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $467.74 Typical High $707.95 | Professional | 62 · Two surgeons | $371.54 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $117.49 Typical High $181.97 | Professional | 80 · Assistant surgeon | $95.50 | $117.49 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $104.71 Typical High $158.49 | Professional | AS · PA/NP assist | $83.18 | $104.71 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $1,096.48 Typical High $8,128.31 | Facility | None | $660.69 | $1,096.48 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,122.02 | Professional | None | $660.69 | $891.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $6,165.95 | Facility | None | $1,174.90 | $2,290.87 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $5,011.87 | Professional | None | $691.83 | $933.25 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $478.63 | Professional | None | $33.11 | $33.11 | $478.63 |
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 $691.83 Median $851.14 Typical High $1,288.25 | Professional | None | $691.83 | $851.14 | $1,288.25 |
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 $354.81 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $93.33 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $645.65 |
Where Kentucky sits
The same service costs 6.2 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 $14,513MT $2,350
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.