How much rates vary
Facilitymedian $1,950 · 10th to 90th $437 to $7,586Professionalmedian $427 · 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 $346.74 Median $436.52 Typical High $851.14 | Facility | None | $346.74 | $436.52 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $524.81 | Professional | None | $346.74 | $398.11 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $338.84 Median $416.87 Typical High $489.78 | Professional | None | $338.84 | $416.87 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $630.96 Typical High $724.44 | Professional | 50 · Both sides | $501.19 | $630.96 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $67.61 Typical High $77.62 | Professional | 80 · Assistant surgeon | $53.70 | $67.61 | $77.62 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $58.88 Typical High $67.61 | Professional | AS · PA/NP assist | $46.77 | $58.88 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $602.56 Typical High $2,041.74 | Facility | None | $323.59 | $602.56 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $630.96 | Professional | None | $380.19 | $512.86 | $630.96 |
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 $389.05 Median $489.78 Typical High $2,041.74 | Professional | None | $389.05 | $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 $407.38 Median $489.78 Typical High $724.44 | Professional | None | $407.38 | $489.78 | $724.44 |
2 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 $263.03 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $302.00 |
Where Kentucky sits
The same service costs 5.1 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 $6,741MT $1,322
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.