How much rates vary
Facilitymedian $2,570 · 10th to 90th $617 to $8,511Professionalmedian $550 · 10th to 90th $437 to $933
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 $467.74 Median $575.44 Typical High $2,630.27 | Facility | None | $467.74 | $575.44 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $776.25 | Professional | None | $467.74 | $537.03 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $8,709.64 | Facility | None | $954.99 | $2,884.03 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $933.25 | Professional | None | $436.52 | $537.03 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $812.83 Typical High $1,412.54 | Professional | 50 · Both sides | $660.69 | $812.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $87.10 Typical High $151.36 | Professional | 80 · Assistant surgeon | $70.79 | $87.10 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $75.86 Typical High $131.83 | Professional | AS · PA/NP assist | $61.66 | $75.86 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $426.58 Median $812.83 Typical High $5,888.44 | Facility | None | $426.58 | $812.83 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $831.76 | Professional | None | $457.09 | $676.08 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $4,365.16 | Facility | None | $602.56 | $1,862.09 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $4,466.84 | Professional | None | $512.86 | $676.08 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $316.23 | Professional | None | $33.11 | $33.11 | $316.23 |
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 $501.19 Median $630.96 Typical High $954.99 | Professional | None | $501.19 | $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 $234.42 Median $263.03 Typical High $346.74 | Professional | 52 · Reduced service | $234.42 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $346.74 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $46.77 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $478.63 |
Where Kentucky 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.