How much rates vary
Facilitymedian $3,020 · 10th to 90th $741 to $8,318Professionalmedian $631 · 10th to 90th $417 to $1,122
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 $436.52 Median $5,370.32 Typical High $8,317.64 | Facility | None | $436.52 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $1,202.26 | Professional | None | $426.58 | $467.74 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | None | $758.58 | $758.58 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $8,511.38 | Facility | None | $691.83 | $1,412.54 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $1,000.00 | Professional | None | $398.11 | $630.96 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $398.11 Typical High $630.96 | Professional | 62 · Two surgeons | $288.40 | $398.11 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $104.71 Typical High $177.83 | Professional | 80 · Assistant surgeon | $72.44 | $104.71 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $89.13 Typical High $151.36 | Professional | AS · PA/NP assist | $63.10 | $89.13 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,288.25 | Professional | None | $501.19 | $741.31 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,288.25 | Professional | None | $416.87 | $512.86 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,122.02 | Professional | None | $457.09 | $660.69 | $1,122.02 |
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 $213.80 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $346.74 |
Where Georgia sits
The same service costs 7.9 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 $10,909MT $1,384
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.