How much rates vary
Facilitymedian $1,318 · 10th to 90th $437 to $2,884Professionalmedian $479 · 10th to 90th $372 to $813
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 $407.38 Median $436.52 Typical High $851.14 | Facility | None | $407.38 | $436.52 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $562.34 | Professional | None | $407.38 | $436.52 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,884.03 | Facility | None | $602.56 | $1,698.24 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $812.83 | Professional | None | $371.54 | $467.74 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $74.13 Typical High $128.82 | Professional | 80 · Assistant surgeon | $58.88 | $74.13 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $66.07 Typical High $112.20 | Professional | AS · PA/NP assist | $51.29 | $66.07 | $112.20 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $2,041.74 | Facility | None | $389.05 | $630.96 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $645.65 | Professional | None | $436.52 | $549.54 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,318.26 Typical High $1,479.11 | Facility | None | $478.63 | $1,318.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $4,073.80 | Professional | None | $407.38 | $575.44 | $4,073.80 |
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 $707.95 Median $1,174.90 Typical High $3,890.45 | Facility | None | $707.95 | $1,174.90 | $3,890.45 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $794.33 | Professional | None | $416.87 | $562.34 | $794.33 |
12 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 Facility Modifier 52 · Reduced service Typical Low $204.17 Median $218.78 Typical High $389.05 | Facility | 52 · Reduced service | $204.17 | $218.78 | $389.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $154.88 | Facility | 53 · Discontinued | $83.18 | $87.10 | $154.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $575.44 | Facility | 54 · Surgery only | $309.03 | $331.13 | $575.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $114.82 | Facility | 55 · Aftercare only | $61.66 | $66.07 | $114.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $77.62 | Facility | 56 · Pre-op care only | $40.74 | $43.65 | $77.62 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $537.03 | Facility | 78 · Unplanned return to OR | $288.40 | $309.03 | $537.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $363.08 |
Where Kentucky sits
The same service costs 4.8 times more in Colorado than in North Dakota. 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 $6,549ND $1,369
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.