How much rates vary
Facilitymedian $1,349 · 10th to 90th $398 to $3,020Professionalmedian $295 · 10th to 90th $229 to $741
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 $229.09 Median $354.81 Typical High $1,778.28 | Facility | None | $229.09 | $354.81 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $407.38 | Professional | None | $229.09 | $263.03 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $741.31 | Professional | None | $229.09 | $295.12 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $446.68 Typical High $1,122.02 | Professional | 50 · Both sides | $346.74 | $446.68 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $186.21 Typical High $467.74 | Professional | 62 · Two surgeons | $144.54 | $186.21 | $467.74 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $398.11 Typical High $2,691.53 | Facility | None | $245.47 | $398.11 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $416.87 | Professional | None | $251.19 | $331.13 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,318.26 Typical High $1,995.26 | Facility | None | $446.68 | $1,318.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $3,981.07 | Professional | None | $257.04 | $363.08 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $138.04 | Professional | None | $33.11 | $33.11 | $138.04 |
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 $275.42 Median $338.84 Typical High $501.19 | Professional | None | $275.42 | $338.84 | $501.19 |
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 $114.82 Median $131.83 Typical High $169.82 | Professional | 52 · Reduced service | $114.82 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $69.18 | Professional | 53 · Discontinued | $46.77 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $239.88 |
Where Kentucky sits
The same service costs 7.3 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 $6,269MT $863
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.