How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $10,471Professionalmedian $851 · 10th to 90th $617 to $4,677
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 $1,778.28 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,778.28 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $794.33 | Professional | None | $588.84 | $676.08 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $9,332.54 | Facility | None | $1,318.26 | $3,890.45 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,071.52 | Professional | None | $630.96 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $501.19 Typical High $660.69 | Professional | 62 · Two surgeons | $398.11 | $501.19 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $125.89 Typical High $169.82 | Professional | 80 · Assistant surgeon | $102.33 | $125.89 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $109.65 Typical High $147.91 | Professional | AS · PA/NP assist | $89.13 | $109.65 | $147.91 |
BCBS Kansas City Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $954.99 | Professional | None | $602.56 | $676.08 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $4,466.84 | Facility | None | $758.58 | $3,311.31 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,258.93 | Professional | None | $602.56 | $691.83 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $4,365.16 Typical High $13,489.63 | Facility | None | $954.99 | $4,365.16 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $4,677.35 Typical High $4,677.35 | Professional | None | $758.58 | $4,677.35 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $9,772.37 | Facility | None | $1,258.93 | $3,981.07 | $9,772.37 |
United Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,548.82 | Professional | None | $602.56 | $891.25 | $1,548.82 |
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 $295.12 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $426.58 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $426.58 | $501.19 |
Where Missouri 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.