How much rates vary
Facilitymedian $759 · 10th to 90th $380 to $7,244Professionalmedian $427 · 10th to 90th $324 to $708
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 $389.05 Median $524.81 Typical High $831.76 | Facility | None | $389.05 | $524.81 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $831.76 | Professional | None | $389.05 | $436.52 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $9,120.11 | Facility | None | $741.31 | $1,047.13 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $512.86 | Professional | None | $316.23 | $398.11 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $245.47 Typical High $323.59 | Professional | 62 · Two surgeons | $199.53 | $245.47 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $63.10 Typical High $79.43 | Professional | 80 · Assistant surgeon | $51.29 | $63.10 | $79.43 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $54.95 Typical High $70.79 | Professional | AS · PA/NP assist | $44.67 | $54.95 | $70.79 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $363.08 Typical High $575.44 | Facility | None | $302.00 | $363.08 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $588.84 | Professional | None | $354.81 | $501.19 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $794.33 | Facility | None | $34.67 | $512.86 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $2,041.74 | Professional | None | $371.54 | $707.95 | $2,041.74 |
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 $407.38 Median $549.54 Typical High $758.58 | Professional | None | $407.38 | $549.54 | $758.58 |
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 $194.98 Median $213.80 Typical High $281.84 | Professional | 52 · Reduced service | $194.98 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $114.82 | Professional | 53 · Discontinued | $77.62 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $426.58 | Professional | 54 · Surgery only | $295.12 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $85.11 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $398.11 |
Where Kentucky sits
The same service costs 6.7 times more in Colorado than in Arkansas. 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 $6,451AR $969
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.