How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,570 to $17,783Professionalmedian $759 · 10th to 90th $575 to $1,148
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 $741.31 Median $3,388.44 Typical High $11,481.54 | Facility | None | $741.31 | $3,388.44 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $933.25 | Professional | None | $537.03 | $575.44 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,174.90 | Professional | None | $630.96 | $851.14 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,023.29 | Professional | None | $575.44 | $707.95 | $1,023.29 |
Denver HMP Setting Facility Modifier None Typical Low $575.44 Median $724.44 Typical High $1,380.38 | Facility | None | $575.44 | $724.44 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,202.26 | Professional | None | $602.56 | $758.58 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $5,011.87 | Facility | None | $549.54 | $1,096.48 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,023.29 | Professional | None | $478.63 | $562.34 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $5,370.32 Typical High $15,488.17 | Facility | None | $2,511.89 | $5,370.32 | $15,488.17 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,122.02 | Professional | None | $549.54 | $707.95 | $1,122.02 |
10 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 $275.42 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $134.90 | Professional | 53 · Discontinued | $109.65 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $831.76 Typical High $1,288.25 | Professional | 50 · Both sides | $630.96 | $831.76 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $346.74 Typical High $549.54 | Professional | 62 · Two surgeons | $269.15 | $346.74 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $89.13 Typical High $138.04 | Professional | 80 · Assistant surgeon | $67.61 | $89.13 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $77.62 Typical High $120.23 | Professional | AS · PA/NP assist | $58.88 | $77.62 | $120.23 |
Where Colorado sits
The same service costs 6.0 times more in Wisconsin 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
WI $11,096MT $1,846
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.