How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,175 to $12,882Professionalmedian $933 · 10th to 90th $692 to $2,455
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $954.99 | Professional | None | $630.96 | $741.31 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,288.25 | Professional | None | $758.58 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,445.44 Typical High $1,905.46 | Professional | 50 · Both sides | $1,148.15 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $602.56 Typical High $794.33 | Professional | 62 · Two surgeons | $478.63 | $602.56 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $151.36 Typical High $199.53 | Professional | 80 · Assistant surgeon | $123.03 | $151.36 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $134.90 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $134.90 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $977.24 | Professional | None | $676.08 | $724.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $6,918.31 | Facility | None | $645.65 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,548.82 | Professional | None | $630.96 | $812.83 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $5,011.87 Typical High $26,915.35 | Facility | None | $977.24 | $5,011.87 | $26,915.35 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $6,456.54 | Professional | None | $758.58 | $1,288.25 | $6,456.54 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,513.56 | Professional | None | $676.08 | $954.99 | $1,513.56 |
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 $323.59 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $478.63 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $125.89 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $588.84 |
Where Missouri 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.