How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $17,378Professionalmedian $692 · 10th to 90th $513 to $1,995
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 $1,698.24 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,698.24 | $5,495.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $776.25 | Professional | None | $467.74 | $549.54 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $5,370.32 Typical High $16,982.44 | Facility | None | $1,412.54 | $5,370.32 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $977.24 | Professional | None | $562.34 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,047.13 Typical High $1,479.11 | Professional | 50 · Both sides | $831.76 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $89.13 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $97.72 Typical High $138.04 | Professional | AS · PA/NP assist | $77.62 | $97.72 | $138.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $724.44 | Professional | None | $512.86 | $549.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,365.16 Typical High $10,471.29 | Facility | None | $741.31 | $4,365.16 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,096.48 | Professional | None | $457.09 | $575.44 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $5,888.44 Typical High $26,302.68 | Facility | None | $831.76 | $5,888.44 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $5,248.07 | Professional | None | $549.54 | $912.01 | $5,248.07 |
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 $478.63 Median $691.83 Typical High $1,096.48 | Professional | None | $478.63 | $691.83 | $1,096.48 |
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 $229.09 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $229.09 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $93.33 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $346.74 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $46.77 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $323.59 | $389.05 | $426.58 |
Where Missouri 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.