How much rates vary
Facilitymedian $3,715 · 10th to 90th $912 to $12,303Professionalmedian $933 · 10th to 90th $741 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 $812.83 Median $912.01 Typical High $4,897.79 | Facility | None | $812.83 | $912.01 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,445.44 | Professional | None | $794.33 | $891.25 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $5,754.40 Typical High $14,454.40 | Facility | None | $1,995.26 | $5,754.40 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,258.93 | Professional | None | $741.31 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $588.84 Typical High $794.33 | Professional | 62 · Two surgeons | $467.74 | $588.84 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $147.91 Typical High $199.53 | Professional | 80 · Assistant surgeon | $117.49 | $147.91 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $128.82 Typical High $177.83 | Professional | AS · PA/NP assist | $104.71 | $128.82 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,348.96 Typical High $4,786.30 | Facility | None | $812.83 | $1,348.96 | $4,786.30 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,380.38 | Professional | None | $812.83 | $1,174.90 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,311.31 Typical High $4,168.69 | Facility | None | $1,445.44 | $3,311.31 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $5,495.41 | Professional | None | $851.14 | $1,258.93 | $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 $812.83 Median $1,230.27 Typical High $1,698.24 | Professional | None | $812.83 | $1,230.27 | $1,698.24 |
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 $398.11 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $398.11 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $158.49 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $724.44 |
Where Kentucky 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.