How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,318 to $16,218Professionalmedian $1,318 · 10th to 90th $955 to $3,467
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 $1,202.26 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,202.26 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,187.76 | Professional | None | $912.01 | $1,071.52 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $933.25 Typical High $1,479.11 | Professional | None | $120.23 | $933.25 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $6,025.60 Typical High $13,803.84 | Facility | None | $1,513.56 | $6,025.60 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,348.96 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,041.74 Typical High $2,951.21 | Professional | 50 · Both sides | $1,659.59 | $2,041.74 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,258.93 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $316.23 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $199.53 Typical High $275.42 | Professional | AS · PA/NP assist | $151.36 | $199.53 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,412.54 | Professional | None | $977.24 | $1,047.13 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $12,882.50 | Facility | None | $977.24 | $4,168.69 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,187.76 | Professional | None | $891.25 | $1,148.15 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $6,025.60 Typical High $26,302.68 | Facility | None | $1,174.90 | $6,025.60 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $7,943.28 | Professional | None | $1,096.48 | $1,778.28 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $13,489.63 | Facility | None | $1,174.90 | $5,248.07 | $13,489.63 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,137.96 | Professional | None | $954.99 | $1,380.38 | $2,137.96 |
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 $457.09 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $457.09 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $831.76 |
Where Missouri 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.