How much rates vary
Facilitymedian $1,175 · 10th to 90th $380 to $9,120Professionalmedian $1,175 · 10th to 90th $977 to $2,042
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 $1,174.90 Median $1,174.90 Typical High $1,445.44 | Facility | None | $1,174.90 | $1,174.90 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,174.90 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,120.11 Typical High $11,220.18 | Facility | None | $758.58 | $9,120.11 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,737.80 | Professional | None | $977.24 | $1,148.15 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $275.42 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $239.88 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,778.28 | Facility | None | $954.99 | $1,148.15 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,548.82 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,041.74 | Facility | None | $34.67 | $512.86 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $5,623.41 | Professional | None | $1,148.15 | $1,737.80 | $5,623.41 |
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 $1,174.90 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,737.80 | $2,238.72 |
7 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 $588.84 Median $588.84 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $1,000.00 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | GC · Resident with teaching physician | $1,380.38 | $1,380.38 | $1,380.38 |
Where Kentucky sits
The same service costs 6.3 times more in Colorado than in Maryland. 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 $11,778MD $1,881
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.