How much rates vary
Facilitymedian $1,479 · 10th to 90th $447 to $4,169Professionalmedian $437 · 10th to 90th $339 to $631
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 $363.08 Median $446.68 Typical High $851.14 | Facility | None | $363.08 | $446.68 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $588.84 | Professional | None | $363.08 | $407.38 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $501.19 | Professional | None | $338.84 | $426.58 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $630.96 Typical High $758.58 | Professional | 50 · Both sides | $512.86 | $630.96 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $67.61 Typical High $81.28 | Professional | 80 · Assistant surgeon | $54.95 | $67.61 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $58.88 Typical High $70.79 | Professional | AS · PA/NP assist | $47.86 | $58.88 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $630.96 Typical High $2,041.74 | Facility | None | $380.19 | $630.96 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $645.65 | Professional | None | $426.58 | $524.81 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,318.26 Typical High $1,584.89 | Facility | None | $34.67 | $1,318.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $2,041.74 | Professional | None | $398.11 | $489.78 | $2,041.74 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $741.31 | Professional | None | $416.87 | $501.19 | $741.31 |
3 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 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $269.15 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $309.03 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 79 · Unrelated procedure after surgery | $501.19 | $501.19 | $501.19 |
Where Kentucky sits
The same service costs 4.9 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 $6,755MT $1,384
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.