How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,000 to $8,913Professionalmedian $1,622 · 10th to 90th $1,230 to $2,455
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,230.27 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $8,912.51 | Facility | None | $3,467.37 | $5,248.07 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,778.28 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,513.56 | $2,137.96 |
Denver HMP Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,818.38 | Facility | None | $1,096.48 | $1,479.11 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,584.89 | $2,511.89 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $2,398.83 | Facility | None | $1,148.15 | $2,290.87 | $2,398.83 |
Select Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,174.90 | $1,819.70 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,513.56 | $2,398.83 |
9 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 $588.84 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $707.95 Typical High $1,230.27 | Professional | 62 · Two surgeons | $524.81 | $707.95 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $177.83 Typical High $316.23 | Professional | 80 · Assistant surgeon | $134.90 | $177.83 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $154.88 Typical High $275.42 | Professional | AS · PA/NP assist | $117.49 | $154.88 | $275.42 |
Where Colorado sits
The same service costs 5.9 times more in Alabama 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
AL $10,682MD $1,821
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.