How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,175 to $10,000Professionalmedian $1,698 · 10th to 90th $1,148 to $3,162
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 $1,230.27 Median $6,309.57 Typical High $10,000.00 | Facility | None | $1,230.27 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,230.27 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $11,220.18 | Facility | None | $1,071.52 | $1,905.46 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,698.24 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,071.52 Typical High $1,778.28 | Professional | 62 · Two surgeons | $776.25 | $1,071.52 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $295.12 Typical High $478.63 | Professional | 80 · Assistant surgeon | $194.98 | $295.12 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $239.88 Typical High $398.11 | Professional | AS · PA/NP assist | $169.82 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,265.80 Typical High $6,025.60 | Facility | None | $1,513.56 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,995.26 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $4,786.30 | Professional | None | $1,380.38 | $1,659.59 | $4,786.30 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,290.87 | Professional | None | $2,238.72 | $2,238.72 | $2,290.87 |
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 $1,023.29 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,023.29 | $1,737.80 | $3,467.37 |
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 $616.60 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,000.00 |
Where Georgia sits
The same service costs 5.5 times more in Colorado than in West Virginia. 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 $14,842WV $2,709
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.