How much rates vary
Facilitymedian $1,349 · 10th to 90th $257 to $2,884Professionalmedian $200 · 10th to 90th $158 to $316
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 $181.97 Median $257.04 Typical High $1,778.28 | Facility | None | $181.97 | $257.04 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $371.54 | Professional | None | $177.83 | $194.98 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $151.36 Median $190.55 Typical High $281.84 | Professional | None | $151.36 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $95.50 Median $120.23 Typical High $177.83 | Professional | 62 · Two surgeons | $95.50 | $120.23 | $177.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $24.55 Median $30.20 Typical High $45.71 | Professional | 80 · Assistant surgeon | $24.55 | $30.20 | $45.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $21.38 Median $26.92 Typical High $39.81 | Professional | AS · PA/NP assist | $21.38 | $26.92 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $2,818.38 | Facility | None | $181.97 | $295.12 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $309.03 | Professional | None | $169.82 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $1,318.26 Typical High $2,089.30 | Facility | None | $316.23 | $1,318.26 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $1,348.96 | Professional | None | $190.55 | $257.04 | $1,348.96 |
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 $169.82 Median $263.03 Typical High $363.08 | Professional | None | $169.82 | $263.03 | $363.08 |
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 $89.13 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $131.83 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $134.90 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $123.03 | $134.90 | $165.96 |
Where Kentucky sits
The same service costs 7.6 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 $4,667MT $611
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.