How much rates vary
Facilitymedian $2,291 · 10th to 90th $646 to $8,318Professionalmedian $631 · 10th to 90th $501 to $955
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 $524.81 Median $645.65 Typical High $1,047.13 | Facility | None | $524.81 | $645.65 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $831.76 | Professional | None | $512.86 | $588.84 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $954.99 | Professional | None | $501.19 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $933.25 Typical High $1,445.44 | Professional | 50 · Both sides | $741.31 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $100.00 Typical High $154.88 | Professional | 80 · Assistant surgeon | $79.43 | $100.00 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $87.10 Typical High $134.90 | Professional | AS · PA/NP assist | $69.18 | $87.10 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $5,888.44 | Facility | None | $549.54 | $912.01 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $933.25 | Professional | None | $512.86 | $758.58 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $4,466.84 | Facility | None | $1,000.00 | $1,862.09 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $4,365.16 | Professional | None | $575.44 | $758.58 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $363.08 | Professional | None | $33.11 | $33.11 | $363.08 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,071.52 | Professional | None | $588.84 | $724.44 | $1,071.52 |
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 $263.03 Median $295.12 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $58.88 Typical High $75.86 | Professional | 56 · Pre-op care only | $52.48 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $537.03 |
Where Kentucky sits
The same service costs 5.6 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 $11,084MT $1,977
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.