How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $8,710Professionalmedian $933 · 10th to 90th $741 to $5,888
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $891.25 | Professional | None | $741.31 | $812.83 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,202.26 | Professional | None | $758.58 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $776.25 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $199.53 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $169.82 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,122.02 | Professional | None | $707.95 | $794.33 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $4,365.16 | Facility | None | $602.56 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,621.81 | Professional | None | $758.58 | $851.14 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $16,595.87 | Facility | None | $1,023.29 | $4,365.16 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $5,888.44 Typical High $5,888.44 | Professional | None | $954.99 | $5,888.44 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,949.84 | Professional | None | $741.31 | $1,122.02 | $1,949.84 |
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 $371.54 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $630.96 |
Where Missouri sits
The same service costs 4.2 times more in Colorado than in Hawaii. 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 $9,583HI $2,259
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.