How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $15,849Professionalmedian $891 · 10th to 90th $661 to $3,020
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 $1,071.52 Median $5,128.61 Typical High $12,882.50 | Facility | None | $1,071.52 | $5,128.61 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,479.11 | Professional | None | $602.56 | $724.44 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $436.52 Typical High $1,000.00 | Professional | None | $134.90 | $436.52 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,380.38 | $3,981.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,258.93 | Professional | None | $707.95 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,380.38 Typical High $1,905.46 | Professional | 50 · Both sides | $1,071.52 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $575.44 Typical High $794.33 | Professional | 62 · Two surgeons | $446.68 | $575.44 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $147.91 Typical High $204.17 | Professional | 80 · Assistant surgeon | $114.82 | $147.91 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $128.82 Typical High $177.83 | Professional | AS · PA/NP assist | $100.00 | $128.82 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $933.25 | Professional | None | $660.69 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,495.41 Typical High $15,488.17 | Facility | None | $741.31 | $5,495.41 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,479.11 | Professional | None | $602.56 | $776.25 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $5,011.87 Typical High $26,915.35 | Facility | None | $954.99 | $5,011.87 | $26,915.35 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $7,244.36 | Professional | None | $724.44 | $1,202.26 | $7,244.36 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,412.54 | Professional | None | $630.96 | $912.01 | $1,412.54 |
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 $302.00 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $562.34 |
Where Missouri 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.