How much rates vary
Facilitymedian $3,467 · 10th to 90th $631 to $10,000Professionalmedian $776 · 10th to 90th $525 to $1,318
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 $1,348.96 Median $6,025.60 Typical High $13,803.84 | Facility | None | $1,348.96 | $6,025.60 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,122.02 | Professional | None | $562.34 | $562.34 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,659.59 Typical High $11,481.54 | Facility | None | $588.84 | $1,659.59 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,258.93 | Professional | None | $524.81 | $776.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,202.26 Typical High $1,905.46 | Professional | 50 · Both sides | $831.76 | $1,202.26 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $134.90 Typical High $208.93 | Professional | 80 · Assistant surgeon | $87.10 | $134.90 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $112.20 Typical High $177.83 | Professional | AS · PA/NP assist | $77.62 | $112.20 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $5,623.41 | Facility | None | $602.56 | $4,168.69 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,445.44 | Professional | None | $616.60 | $870.96 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,995.26 | Professional | None | $588.84 | $645.65 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,479.11 | Professional | None | $489.78 | $812.83 | $1,479.11 |
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 $275.42 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $436.52 |
Where Georgia sits
The same service costs 7.9 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 $13,941MT $1,762
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.