How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,445 to $13,490Professionalmedian $1,660 · 10th to 90th $1,122 to $5,495
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 $2,511.89 Median $6,165.95 Typical High $10,715.19 | Facility | None | $2,511.89 | $6,165.95 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,230.27 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $6,606.93 Typical High $12,302.69 | Facility | None | $1,479.11 | $6,606.93 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,621.81 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,023.29 Typical High $1,348.96 | Professional | 62 · Two surgeons | $794.33 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $257.04 Typical High $346.74 | Professional | 80 · Assistant surgeon | $199.53 | $257.04 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $223.87 Typical High $302.00 | Professional | AS · PA/NP assist | $173.78 | $223.87 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,288.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $5,128.61 Typical High $11,748.98 | Facility | None | $1,862.09 | $5,128.61 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,348.96 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $5,888.44 Typical High $19,952.62 | Facility | None | $1,258.93 | $5,888.44 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $8,709.64 | Professional | None | $1,230.27 | $2,187.76 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $6,025.60 Typical High $12,882.50 | Facility | None | $1,174.90 | $6,025.60 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,862.09 | $2,511.89 |
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 $602.56 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $239.88 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $870.96 |
Where Missouri 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.