How much rates vary
Facilitymedian $2,630 · 10th to 90th $692 to $8,511Professionalmedian $617 · 10th to 90th $513 to $891
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 $616.60 Median $794.33 Typical High $1,230.27 | Facility | None | $616.60 | $794.33 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $794.33 | Professional | None | $616.60 | $630.96 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $3,311.31 Typical High $9,332.54 | Facility | None | $1,071.52 | $3,311.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $812.83 | Professional | None | $512.86 | $616.60 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $389.05 Typical High $512.86 | Professional | 62 · Two surgeons | $323.59 | $389.05 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $100.00 Typical High $128.82 | Professional | 80 · Assistant surgeon | $81.28 | $100.00 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $602.56 Typical High $954.99 | Facility | None | $501.19 | $602.56 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $954.99 | Professional | None | $524.81 | $741.31 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,202.26 Typical High $3,715.35 | Facility | None | $34.67 | $1,202.26 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $3,311.31 | Professional | None | $602.56 | $691.83 | $3,311.31 |
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 $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,000.00 | Professional | None | $588.84 | $794.33 | $1,000.00 |
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 $309.03 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $549.54 |
Where Kentucky 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.