How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,380 to $15,488Professionalmedian $1,230 · 10th to 90th $891 to $3,236
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 $2,041.74 Median $6,456.54 Typical High $14,125.38 | Facility | None | $2,041.74 | $6,456.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $3,388.44 | Professional | None | $691.83 | $891.25 | $3,388.44 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,981.07 Typical High $13,182.57 | Facility | None | $1,412.54 | $3,981.07 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,659.59 | Professional | None | $912.01 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $794.33 Typical High $1,047.13 | Professional | 62 · Two surgeons | $575.44 | $794.33 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $204.17 Typical High $269.15 | Professional | 80 · Assistant surgeon | $154.88 | $204.17 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $177.83 Typical High $234.42 | Professional | AS · PA/NP assist | $128.82 | $177.83 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,258.93 | Professional | None | $812.83 | $912.01 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $4,168.69 Typical High $12,022.64 | Facility | None | $1,862.09 | $4,168.69 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $2,041.74 | Professional | None | $851.14 | $1,023.29 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $5,888.44 Typical High $26,302.68 | Facility | None | $1,202.26 | $5,888.44 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,290.87 Typical High $6,760.83 | Professional | None | $954.99 | $2,290.87 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $10,715.19 | Facility | None | $1,513.56 | $4,265.80 | $10,715.19 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $2,344.23 | Professional | None | $933.25 | $1,258.93 | $2,344.23 |
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 $346.74 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $616.60 |
Where Missouri 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.