How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,047 to $11,749Professionalmedian $603 · 10th to 90th $398 to $3,090
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 $512.86 Median $5,128.61 Typical High $10,715.19 | Facility | None | $512.86 | $5,128.61 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $676.08 | Professional | None | $338.84 | $467.74 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $11,748.98 | Facility | None | $1,380.38 | $3,801.89 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $676.08 | Professional | None | $389.05 | $489.78 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $741.31 Typical High $1,023.29 | Professional | 50 · Both sides | $588.84 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $309.03 Typical High $426.58 | Professional | 62 · Two surgeons | $245.47 | $309.03 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $79.43 Typical High $109.65 | Professional | 80 · Assistant surgeon | $63.10 | $79.43 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $69.18 Typical High $95.50 | Professional | AS · PA/NP assist | $54.95 | $69.18 | $95.50 |
BCBS Kansas City Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $776.25 | Professional | None | $398.11 | $616.60 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $5,370.32 | Facility | None | $758.58 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $954.99 | Professional | None | $338.84 | $575.44 | $954.99 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $26,302.68 | Facility | None | $724.44 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $3,090.30 Typical High $4,570.88 | Professional | None | $645.65 | $3,090.30 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $954.99 | Professional | None | $407.38 | $630.96 | $954.99 |
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 $169.82 Median $257.04 Typical High $316.23 | Professional | 52 · Reduced service | $169.82 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $102.33 Typical High $125.89 | Professional | 53 · Discontinued | $69.18 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $257.04 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $95.50 | Professional | 55 · Aftercare only | $51.29 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $51.29 Typical High $63.10 | Professional | 56 · Pre-op care only | $33.88 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $354.81 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $239.88 | $354.81 | $436.52 |
Where Missouri sits
The same service costs 6.5 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 $9,949MT $1,532
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.