How much rates vary
Facilitymedian $3,162 · 10th to 90th $631 to $9,550Professionalmedian $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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $2,089.30 | Professional | None | $776.25 | $776.25 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $10,964.78 | Facility | None | $588.84 | $1,548.82 | $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 $467.74 Median $676.08 Typical High $1,096.48 | Professional | 62 · Two surgeons | $467.74 | $676.08 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $186.21 Typical High $281.84 | Professional | 80 · Assistant surgeon | $120.23 | $186.21 | $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 $602.56 Median $5,370.32 Typical High $6,760.83 | Facility | None | $602.56 | $5,370.32 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,949.84 | Professional | None | $870.96 | $1,230.27 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $2,137.96 | Professional | None | $758.58 | $851.14 | $2,137.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,949.84 | Professional | None | $691.83 | $1,122.02 | $1,949.84 |
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 $389.05 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $616.60 |
Where Georgia sits
The same service costs 6.0 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 $14,230MT $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.