How much rates vary
Facilitymedian $2,512 · 10th to 90th $525 to $8,511Professionalmedian $2,089 · 10th to 90th $1,413 to $4,786
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,445.44 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,318.26 Typical High $1,778.28 | Professional | 62 · Two surgeons | $933.25 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $338.84 Typical High $457.09 | Professional | 80 · Assistant surgeon | $234.42 | $338.84 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $295.12 Typical High $398.11 | Professional | AS · PA/NP assist | $208.93 | $295.12 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,513.56 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $3,801.89 | Professional | None | $1,348.96 | $1,659.59 | $3,801.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $2,951.21 Typical High $10,232.93 | Professional | None | $1,621.81 | $2,951.21 | $10,232.93 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,513.56 | $2,089.30 | $3,019.95 |
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 $645.65 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,096.48 |
Where Missouri 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.