How much rates vary
Facilitymedian $1,820 · 10th to 90th $589 to $7,586Professionalmedian $525 · 10th to 90th $407 to $851
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 $524.81 Median $645.65 Typical High $2,630.27 | Facility | None | $524.81 | $645.65 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $660.69 | Professional | None | $524.81 | $602.56 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,511.38 | Facility | None | $954.99 | $2,884.03 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $741.31 | Professional | None | $407.38 | $501.19 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $741.31 Typical High $1,096.48 | Professional | 50 · Both sides | $616.60 | $741.31 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $316.23 Typical High $457.09 | Professional | 62 · Two surgeons | $257.04 | $316.23 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $79.43 Typical High $117.49 | Professional | 80 · Assistant surgeon | $66.07 | $79.43 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $69.18 Typical High $102.33 | Professional | AS · PA/NP assist | $57.54 | $69.18 | $102.33 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $2,041.74 | Facility | None | $549.54 | $912.01 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $933.25 | Professional | None | $575.44 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $1,862.09 | Facility | None | $1,023.29 | $1,445.44 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $3,388.44 | Professional | None | $524.81 | $724.44 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $234.42 | Professional | None | $33.11 | $33.11 | $234.42 |
United Setting Facility Modifier None Typical Low $457.09 Median $794.33 Typical High $2,454.71 | Facility | None | $457.09 | $794.33 | $2,454.71 |
United Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,071.52 | Professional | None | $436.52 | $645.65 | $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 $263.03 Median $302.00 Typical High $323.59 | Professional | 52 · Reduced service | $263.03 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $64.57 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $457.09 |
Where Kentucky sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,475DE $1,401
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.