How much rates vary
Facilitymedian $2,630 · 10th to 90th $891 to $8,913Professionalmedian $1,000 · 10th to 90th $776 to $1,514
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 $891.25 Median $1,047.13 Typical High $8,511.38 | Facility | None | $891.25 | $1,047.13 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,230.27 | Professional | None | $891.25 | $933.25 | $1,230.27 |
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 $776.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $776.25 | $1,000.00 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,479.11 Typical High $1,905.46 | Professional | 50 · Both sides | $1,148.15 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $630.96 Typical High $812.83 | Professional | 62 · Two surgeons | $489.78 | $630.96 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $158.49 Typical High $204.17 | Professional | 80 · Assistant surgeon | $123.03 | $158.49 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $138.04 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $138.04 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $870.96 Typical High $1,348.96 | Facility | None | $724.44 | $870.96 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,412.54 | Professional | None | $831.76 | $1,174.90 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $1,445.44 Typical High $6,165.95 | Facility | None | $34.67 | $1,445.44 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $5,495.41 | Professional | None | $870.96 | $1,348.96 | $5,495.41 |
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 $851.14 Median $1,202.26 Typical High $1,659.59 | Professional | None | $851.14 | $1,202.26 | $1,659.59 |
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 $446.68 Median $467.74 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $467.74 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $912.01 | Professional | 54 · Surgery only | $676.08 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $851.14 |
Where Kentucky sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.