How much rates vary
Facilitymedian $3,715 · 10th to 90th $891 to $10,715Professionalmedian $1,479 · 10th to 90th $955 to $2,570
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 $1,096.48 Median $6,309.57 Typical High $13,803.84 | Facility | None | $1,096.48 | $6,309.57 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,174.90 | $2,884.03 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $1,318.26 Typical High $1,905.46 | Professional | None | $208.93 | $1,318.26 | $1,905.46 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | 80 · Assistant surgeon | $213.80 | $309.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $11,481.54 | Facility | None | $812.83 | $1,819.70 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,398.83 | Professional | None | $954.99 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,344.23 Typical High $3,801.89 | Professional | 50 · Both sides | $1,621.81 | $2,344.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $977.24 Typical High $1,621.81 | Professional | 62 · Two surgeons | $691.83 | $977.24 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $263.03 Typical High $407.38 | Professional | 80 · Assistant surgeon | $169.82 | $263.03 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $218.78 Typical High $354.81 | Professional | AS · PA/NP assist | $151.36 | $218.78 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,584.89 | Professional | None | $977.24 | $1,288.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,168.69 Typical High $5,623.41 | Facility | None | $831.76 | $4,168.69 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,778.28 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,230.27 | $4,073.80 |
Oscar Health Setting Facility Modifier None Typical Low $7,585.78 Median $10,000.00 Typical High $18,197.01 | Facility | None | $7,585.78 | $10,000.00 | $18,197.01 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,862.09 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $11,481.54 | Facility | None | $1,513.56 | $3,715.35 | $11,481.54 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $2,754.23 | Professional | None | $977.24 | $1,621.81 | $2,754.23 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $870.96 |
Where Georgia sits
The same service costs 4.2 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 $14,362MT $3,396
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.