How much rates vary
Facilitymedian $3,236 · 10th to 90th $646 to $10,233Professionalmedian $1,000 · 10th to 90th $646 to $1,698
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 $741.31 Median $5,370.32 Typical High $18,197.01 | Facility | None | $741.31 | $5,370.32 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,949.84 | Professional | None | $724.44 | $794.33 | $1,949.84 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,230.27 | Professional | None | $616.60 | $724.44 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $12,302.69 | Facility | None | $588.84 | $1,548.82 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,621.81 | Professional | None | $645.65 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,548.82 Typical High $2,511.89 | Professional | 50 · Both sides | $1,096.48 | $1,548.82 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $645.65 Typical High $1,071.52 | Professional | 62 · Two surgeons | $457.09 | $645.65 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $173.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $114.82 | $173.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $144.54 Typical High $229.09 | Professional | AS · PA/NP assist | $102.33 | $144.54 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,370.32 Typical High $6,760.83 | Facility | None | $602.56 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,862.09 | Professional | None | $812.83 | $1,148.15 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $2,754.23 | Professional | None | $741.31 | $831.76 | $2,754.23 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,258.93 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,905.46 | Professional | None | $645.65 | $1,047.13 | $1,905.46 |
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 $363.08 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $575.44 |
Where Georgia sits
The same service costs 6.1 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 $13,882MT $2,270
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.