How much rates vary
Facilitymedian $2,570 · 10th to 90th $832 to $8,511Professionalmedian $891 · 10th to 90th $708 to $1,413
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 $758.58 Median $933.25 Typical High $8,511.38 | Facility | None | $758.58 | $933.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,288.25 | Professional | None | $758.58 | $870.96 | $1,288.25 |
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 $707.95 Median $870.96 Typical High $1,348.96 | Professional | None | $707.95 | $870.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $138.04 Typical High $218.78 | Professional | 80 · Assistant surgeon | $112.20 | $138.04 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $120.23 Typical High $190.55 | Professional | AS · PA/NP assist | $97.72 | $120.23 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $7,585.78 | Facility | None | $812.83 | $1,318.26 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,348.96 | Professional | None | $812.83 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $4,466.84 | Facility | None | $1,548.82 | $2,290.87 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $6,760.83 | Professional | None | $851.14 | $1,071.52 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $346.74 | Professional | None | $33.11 | $33.11 | $346.74 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,548.82 | Professional | None | $812.83 | $1,000.00 | $1,548.82 |
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 $380.19 Median $436.52 Typical High $575.44 | Professional | 52 · Reduced service | $380.19 | $436.52 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $234.42 | Professional | 53 · Discontinued | $151.36 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $870.96 | Professional | 54 · Surgery only | $562.34 | $660.69 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $173.78 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $114.82 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $812.83 |
Where Kentucky 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.