How much rates vary
Facilitymedian $2,818 · 10th to 90th $759 to $8,710Professionalmedian $1,047 · 10th to 90th $676 to $1,778
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 $758.58 Median $5,370.32 Typical High $8,317.64 | Facility | None | $758.58 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,995.26 | Professional | None | $758.58 | $812.83 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $1,513.56 | Professional | None | $43.65 | $43.65 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $10,964.78 | Facility | None | $707.95 | $1,584.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,698.24 | Professional | None | $676.08 | $1,047.13 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,621.81 Typical High $2,630.27 | Professional | 50 · Both sides | $1,122.02 | $1,621.81 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $676.08 Typical High $1,096.48 | Professional | 62 · Two surgeons | $478.63 | $676.08 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $194.98 Typical High $281.84 | Professional | 80 · Assistant surgeon | $147.91 | $194.98 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $151.36 Typical High $245.47 | Professional | AS · PA/NP assist | $104.71 | $151.36 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $5,370.32 | Facility | None | $741.31 | $4,073.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,949.84 | Professional | None | $851.14 | $1,230.27 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,698.24 | Professional | None | $794.33 | $891.25 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,288.25 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,905.46 | Professional | None | $691.83 | $1,096.48 | $1,905.46 |
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 $380.19 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $602.56 |
Where Georgia sits
The same service costs 5.7 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 $13,613MT $2,377
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.