How much rates vary
Facilitymedian $2,630 · 10th to 90th $776 to $8,710Professionalmedian $741 · 10th to 90th $617 to $1,175
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 $630.96 Median $794.33 Typical High $3,235.94 | Facility | None | $630.96 | $794.33 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,047.13 | Professional | None | $630.96 | $724.44 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,122.02 | Professional | None | $616.60 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,122.02 Typical High $1,698.24 | Professional | 50 · Both sides | $912.01 | $1,122.02 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $467.74 Typical High $707.95 | Professional | 62 · Two surgeons | $380.19 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $177.83 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $104.71 Typical High $158.49 | Professional | AS · PA/NP assist | $85.11 | $104.71 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $1,096.48 Typical High $5,888.44 | Facility | None | $676.08 | $1,096.48 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,148.15 | Professional | None | $758.58 | $933.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $4,466.84 | Facility | None | $1,230.27 | $2,290.87 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $5,128.61 | Professional | None | $707.95 | $912.01 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $398.11 | Professional | None | $33.11 | $33.11 | $398.11 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,318.26 | Professional | None | $707.95 | $870.96 | $1,318.26 |
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 $316.23 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $316.23 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $707.95 | Professional | 54 · Surgery only | $478.63 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $141.25 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $660.69 |
Where Kentucky 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.