How much rates vary
Facilitymedian $3,311 · 10th to 90th $562 to $10,715Professionalmedian $562 · 10th to 90th $398 to $1,000
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 $407.38 Median $562.34 Typical High $831.76 | Facility | None | $407.38 | $562.34 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $724.44 | Professional | None | $407.38 | $562.34 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $12,022.64 | Facility | None | $1,584.89 | $4,677.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $562.34 | Professional | None | $389.05 | $467.74 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $707.95 Typical High $831.76 | Professional | 50 · Both sides | $575.44 | $707.95 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $75.86 Typical High $91.20 | Professional | 80 · Assistant surgeon | $61.66 | $75.86 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $66.07 Typical High $77.62 | Professional | AS · PA/NP assist | $53.70 | $66.07 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $8,128.31 | Facility | None | $436.52 | $707.95 | $8,128.31 |
CareSource Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $741.31 | Professional | None | $489.78 | $602.56 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $794.33 Typical High $5,888.44 | Facility | None | $34.67 | $794.33 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $3,235.94 | Professional | None | $457.09 | $645.65 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $436.52 | Professional | None | $33.11 | $33.11 | $436.52 |
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 $512.86 Median $776.25 Typical High $1,230.27 | Professional | None | $512.86 | $776.25 | $1,230.27 |
12 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 Facility Modifier 52 · Reduced service Typical Low $204.17 Median $281.84 Typical High $416.87 | Facility | 52 · Reduced service | $204.17 | $281.84 | $416.87 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $165.96 | Facility | 53 · Discontinued | $81.28 | $112.20 | $165.96 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $630.96 | Facility | 54 · Surgery only | $309.03 | $416.87 | $630.96 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $125.89 | Facility | 55 · Aftercare only | $61.66 | $85.11 | $125.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $83.18 | Facility | 56 · Pre-op care only | $40.74 | $56.23 | $83.18 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $588.84 | Facility | 78 · Unplanned return to OR | $288.40 | $398.11 | $588.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $281.84 Typical High $346.74 | Professional | 52 · Reduced service | $204.17 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $138.04 | Professional | 53 · Discontinued | $81.28 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $524.81 | Professional | 54 · Surgery only | $309.03 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $69.18 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $489.78 |
Where Kentucky sits
The same service costs 9.3 times more in Colorado than in West Virginia. 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 $13,624WV $1,466
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.