How much rates vary
Facilitymedian $2,630 · 10th to 90th $525 to $10,471Professionalmedian $1,318 · 10th to 90th $1,023 to $3,162
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 $5,128.61 Typical High $8,912.51 | Facility | None | $1,698.24 | $5,128.61 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,288.25 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,801.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,187.76 | Professional | None | $977.24 | $1,174.90 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $3,311.31 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $354.81 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $309.03 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,071.52 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $707.95 Typical High $2,691.53 | Facility | None | $489.78 | $707.95 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,023.29 | $1,412.54 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $8,912.51 | Facility | None | $54.95 | $1,230.27 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,630.27 Typical High $7,585.78 | Professional | None | $1,479.11 | $2,630.27 | $7,585.78 |
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 $1,202.26 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,202.26 | $1,862.09 | $3,235.94 |
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 $562.34 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $194.98 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $128.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $912.01 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $912.01 | $977.24 |
Where Missouri sits
The same service costs 7.5 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 $13,030MD $1,737
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.