How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,202 to $8,710Professionalmedian $1,259 · 10th to 90th $794 to $2,291
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 $1,122.02 Median $7,244.36 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,244.36 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $2,454.71 | Professional | None | $741.31 | $977.24 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $1,584.89 Typical High $1,659.59 | Professional | None | $794.33 | $1,584.89 | $1,659.59 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 80 · Assistant surgeon | $245.47 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $8,912.51 | Facility | None | $1,096.48 | $1,949.84 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $2,137.96 | Professional | None | $812.83 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $851.14 Typical High $1,380.38 | Professional | 62 · Two surgeons | $602.56 | $851.14 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $234.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $147.91 | $234.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $186.21 Typical High $309.03 | Professional | AS · PA/NP assist | $134.90 | $186.21 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,548.13 Typical High $5,011.87 | Facility | None | $1,513.56 | $3,548.13 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,511.89 | Professional | None | $933.25 | $1,479.11 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $2,691.53 | Professional | None | $831.76 | $1,047.13 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,187.76 | Professional | None | $933.25 | $1,348.96 | $2,187.76 |
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 $363.08 Median $363.08 Typical High $501.19 | Professional | 52 · Reduced service | $363.08 | $363.08 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $199.53 | Professional | 53 · Discontinued | $147.91 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $741.31 | Professional | 54 · Surgery only | $549.54 | $549.54 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $691.83 |
Where Georgia sits
The same service costs 4.2 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 $11,551MT $2,762
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.