How much rates vary
Facilitymedian $2,188 · 10th to 90th $759 to $7,943Professionalmedian $1,288 · 10th to 90th $851 to $2,138
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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,174.90 | Professional | None | $933.25 | $954.99 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $10,964.78 | Facility | None | $707.95 | $1,584.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,089.30 | Professional | None | $831.76 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $223.87 Typical High $346.74 | Professional | 80 · Assistant surgeon | $147.91 | $223.87 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $186.21 Typical High $302.00 | Professional | AS · PA/NP assist | $151.36 | $186.21 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $5,370.32 | Facility | None | $741.31 | $4,073.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,380.38 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,096.48 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,041.74 | Professional | None | $954.99 | $1,584.89 | $2,041.74 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,344.23 | Professional | None | $831.76 | $1,348.96 | $2,344.23 |
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 $467.74 Median $478.63 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $95.50 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $741.31 |
Where Georgia sits
The same service costs 4.2 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 $12,508MT $2,994
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.