How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,259 to $15,136Professionalmedian $891 · 10th to 90th $676 to $2,089
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 $1,122.02 Median $5,623.41 Typical High $13,182.57 | Facility | None | $1,122.02 | $5,623.41 | $13,182.57 |
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 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,230.27 | Professional | None | $741.31 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,348.96 Typical High $1,819.70 | Professional | 50 · Both sides | $1,122.02 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $776.25 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $141.25 Typical High $194.98 | Professional | 80 · Assistant surgeon | $117.49 | $141.25 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $169.82 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $977.24 | Professional | None | $707.95 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $6,309.57 | Facility | None | $851.14 | $3,801.89 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,548.82 | Professional | None | $616.60 | $812.83 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,073.80 Typical High $26,302.68 | Facility | None | $1,023.29 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $12,022.64 | Professional | None | $758.58 | $1,288.25 | $12,022.64 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $12,022.64 | Facility | None | $1,513.56 | $3,981.07 | $12,022.64 |
United Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,479.11 | Professional | None | $660.69 | $954.99 | $1,479.11 |
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 $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $575.44 |
Where Missouri 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.