How much rates vary
Facilitymedian $1,660 · 10th to 90th $427 to $4,169Professionalmedian $427 · 10th to 90th $288 to $794
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 $288.40 Median $426.58 Typical High $851.14 | Facility | None | $288.40 | $426.58 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $549.54 | Professional | None | $288.40 | $426.58 | $549.54 |
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 $288.40 Median $346.74 Typical High $794.33 | Professional | None | $288.40 | $346.74 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $524.81 Typical High $1,202.26 | Professional | 50 · Both sides | $436.52 | $524.81 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $56.23 Typical High $128.82 | Professional | 80 · Assistant surgeon | $45.71 | $56.23 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $48.98 Typical High $112.20 | Professional | AS · PA/NP assist | $40.74 | $48.98 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $501.19 Typical High $2,691.53 | Facility | None | $269.15 | $501.19 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $512.86 | Professional | None | $316.23 | $426.58 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,659.59 Typical High $1,949.84 | Facility | None | $489.78 | $1,659.59 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $3,715.35 | Professional | None | $323.59 | $524.81 | $3,715.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $173.78 | Professional | None | $33.11 | $33.11 | $173.78 |
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 $354.81 Median $524.81 Typical High $812.83 | Professional | None | $354.81 | $524.81 | $812.83 |
12 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 Facility Modifier 52 · Reduced service Typical Low $144.54 Median $213.80 Typical High $346.74 | Facility | 52 · Reduced service | $144.54 | $213.80 | $346.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $57.54 Median $85.11 Typical High $138.04 | Facility | 53 · Discontinued | $57.54 | $85.11 | $138.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $218.78 Median $323.59 Typical High $524.81 | Facility | 54 · Surgery only | $218.78 | $323.59 | $524.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $43.65 Median $64.57 Typical High $104.71 | Facility | 55 · Aftercare only | $43.65 | $64.57 | $104.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.84 Median $42.66 Typical High $69.18 | Facility | 56 · Pre-op care only | $28.84 | $42.66 | $69.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $489.78 | Facility | 78 · Unplanned return to OR | $204.17 | $302.00 | $489.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $144.54 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $57.54 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $218.78 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $43.65 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $28.84 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $204.17 | $302.00 | $371.54 |
Where Kentucky sits
The same service costs 4.4 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 $6,451MT $1,460
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.