How much rates vary
Facilitymedian $1,820 · 10th to 90th $891 to $9,120Professionalmedian $1,175 · 10th to 90th $933 to $1,778
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 $891.25 Median $1,174.90 Typical High $8,511.38 | Facility | None | $891.25 | $1,174.90 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,096.48 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,332.54 Typical High $11,220.18 | Facility | None | $758.58 | $9,332.54 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,621.81 | Professional | None | $933.25 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $724.44 Typical High $1,000.00 | Professional | 62 · Two surgeons | $588.84 | $724.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $158.49 Typical High $223.87 | Professional | AS · PA/NP assist | $131.83 | $158.49 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $5,888.44 | Facility | None | $1,047.13 | $1,778.28 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,479.11 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,801.89 Typical High $4,466.84 | Facility | None | $34.67 | $3,801.89 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $6,606.93 | Professional | None | $1,148.15 | $1,513.56 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $724.44 | Professional | None | $33.11 | $33.11 | $724.44 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,479.11 | $2,041.74 |
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 $501.19 Median $549.54 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $870.96 |
Where Kentucky 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.