How much rates vary
Facilitymedian $2,570 · 10th to 90th $776 to $8,511Professionalmedian $759 · 10th to 90th $617 to $1,202
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 $776.25 Typical High $2,630.27 | Facility | None | $630.96 | $776.25 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,000.00 | Professional | None | $630.96 | $724.44 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $446.68 | Professional | None | $60.26 | $60.26 | $446.68 |
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 $616.60 Median $758.58 Typical High $1,174.90 | Professional | None | $616.60 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,148.15 Typical High $1,737.80 | Professional | 50 · Both sides | $933.25 | $1,148.15 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $478.63 Typical High $741.31 | Professional | 62 · Two surgeons | $389.05 | $478.63 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $123.03 Typical High $186.21 | Professional | 80 · Assistant surgeon | $97.72 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | AS · PA/NP assist | $87.10 | $107.15 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $1,096.48 Typical High $8,128.31 | Facility | None | $575.44 | $1,096.48 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,122.02 | Professional | None | $741.31 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,862.09 Typical High $5,754.40 | Facility | None | $831.76 | $1,862.09 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $5,248.07 | Professional | None | $707.95 | $933.25 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $426.58 | Professional | None | $33.11 | $33.11 | $426.58 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
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 $478.63 | Professional | 52 · Reduced service | $316.23 | $363.08 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $95.50 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $660.69 |
Where Kentucky 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.