How much rates vary
Facilitymedian $1,380 · 10th to 90th $389 to $8,318Professionalmedian $1,514 · 10th to 90th $1,202 to $2,455
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 $1,380.38 Median $1,380.38 Typical High $1,548.82 | Facility | None | $1,380.38 | $1,380.38 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,380.38 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $11,220.18 | Facility | None | $758.58 | $5,888.44 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $758.58 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $239.88 Typical High $331.13 | Professional | 80 · Assistant surgeon | $190.55 | $239.88 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $165.96 | $213.80 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,348.96 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,862.09 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,398.83 | Facility | None | $34.67 | $691.83 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $7,943.28 | Professional | None | $1,348.96 | $2,041.74 | $7,943.28 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,819.70 | $2,630.27 |
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 $691.83 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,096.48 |
Where Kentucky sits
The same service costs 7.8 times more in Colorado than in Washington. 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 $16,544WA $2,120
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.