How much rates vary
Facilitymedian $1,318 · 10th to 90th $79 to $3,890Professionalmedian $135 · 10th to 90th $65 to $219
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 $69.18 Median $154.88 Typical High $398.11 | Facility | None | $69.18 | $154.88 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $213.80 | Professional | None | $69.18 | $147.91 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,265.80 | Facility | None | $724.44 | $1,995.26 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $117.49 Typical High $177.83 | Professional | None | $64.57 | $117.49 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $177.83 Typical High $263.03 | Professional | 50 · Both sides | $95.50 | $177.83 | $263.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $10.23 Median $20.42 Typical High $28.18 | Professional | 80 · Assistant surgeon | $10.23 | $20.42 | $28.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $8.91 Median $18.20 Typical High $24.55 | Professional | AS · PA/NP assist | $8.91 | $18.20 | $24.55 |
CareSource Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $2,041.74 | Facility | None | $67.61 | $95.50 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $218.78 | Professional | None | $85.11 | $154.88 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $831.76 Typical High $1,479.11 | Facility | None | $34.67 | $831.76 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $158.49 Typical High $851.14 | Professional | None | $70.79 | $158.49 | $851.14 |
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 $457.09 Median $794.33 Typical High $3,981.07 | Facility | None | $457.09 | $794.33 | $3,981.07 |
United Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $245.47 | Professional | None | $81.28 | $147.91 | $245.47 |
10 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 Facility Modifier 52 · Reduced service Typical Low $34.67 Median $41.69 Typical High $87.10 | Facility | 52 · Reduced service | $34.67 | $41.69 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $34.67 | Facility | 53 · Discontinued | $13.80 | $16.60 | $34.67 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $52.48 Median $63.10 Typical High $131.83 | Facility | 54 · Surgery only | $52.48 | $63.10 | $131.83 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $12.59 Typical High $26.30 | Facility | 55 · Aftercare only | $10.47 | $12.59 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.32 Typical High $17.38 | Facility | 56 · Pre-op care only | $6.92 | $8.32 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $54.95 Typical High $85.11 | Professional | 52 · Reduced service | $34.67 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.88 Typical High $33.88 | Professional | 53 · Discontinued | $13.80 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $125.89 | Professional | 54 · Surgery only | $52.48 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.60 Typical High $25.70 | Professional | 55 · Aftercare only | $10.47 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.96 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.92 | $10.96 | $16.98 |
Where Kentucky sits
The same service costs 9.7 times more in Colorado than in Montana. 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 $4,351MT $447
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.