How much rates vary
Facilitymedian $1,479 · 10th to 90th $151 to $3,890Professionalmedian $162 · 10th to 90th $76 to $355
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 $79.43 Median $2,511.89 Typical High $6,309.57 | Facility | None | $79.43 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $218.78 | Professional | None | $67.61 | $154.88 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $83.18 | Professional | None | $54.95 | $72.44 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $151.36 Typical High $263.03 | Professional | None | $77.62 | $151.36 | $263.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $223.87 Typical High $398.11 | Professional | 50 · Both sides | $117.49 | $223.87 | $398.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $12.30 Median $23.99 Typical High $44.67 | Professional | 80 · Assistant surgeon | $12.30 | $23.99 | $44.67 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $10.96 Median $21.38 Typical High $39.81 | Professional | AS · PA/NP assist | $10.96 | $21.38 | $39.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $66.07 Median $169.82 Typical High $234.42 | Professional | None | $66.07 | $169.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,548.82 Typical High $1,862.09 | Facility | None | $707.95 | $1,548.82 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $169.82 Typical High $363.08 | Professional | None | $72.44 | $169.82 | $363.08 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $870.96 Typical High $3,090.30 | Facility | None | $54.95 | $870.96 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $616.60 Typical High $1,318.26 | Professional | None | $162.18 | $616.60 | $1,318.26 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $354.81 | Professional | None | $79.43 | $169.82 | $354.81 |
5 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 $33.88 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $33.88 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $29.51 Typical High $32.36 | Professional | 53 · Discontinued | $13.49 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $112.20 Typical High $120.23 | Professional | 54 · Surgery only | $50.12 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $22.39 Typical High $23.99 | Professional | 55 · Aftercare only | $10.00 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.76 | $14.79 | $16.22 |
Where Missouri 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.