How much rates vary
Facilitymedian $2,951 · 10th to 90th $813 to $8,710Professionalmedian $891 · 10th to 90th $603 to $1,479
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 $1,202.26 Median $6,165.95 Typical High $15,488.17 | Facility | None | $1,202.26 | $6,165.95 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $954.99 | Professional | None | $630.96 | $645.65 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $8,912.51 | Facility | None | $794.33 | $1,584.89 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,445.44 | Professional | None | $524.81 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $588.84 Typical High $1,023.29 | Professional | 62 · Two surgeons | $436.52 | $588.84 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $165.96 Typical High $269.15 | Professional | 80 · Assistant surgeon | $107.15 | $165.96 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $128.82 Typical High $229.09 | Professional | AS · PA/NP assist | $95.50 | $128.82 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,467.37 Typical High $4,677.35 | Facility | None | $741.31 | $3,467.37 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,778.28 | Professional | None | $691.83 | $1,071.52 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,479.11 | Professional | None | $724.44 | $851.14 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $2,041.74 | Professional | None | $588.84 | $1,047.13 | $2,041.74 |
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 $316.23 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $616.60 | Professional | 54 · Surgery only | $478.63 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $575.44 |
Where Georgia sits
The same service costs 5.4 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 $11,084MT $2,070
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.