How much rates vary
Facilitymedian $1,820 · 10th to 90th $851 to $9,120Professionalmedian $1,148 · 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 $851.14 Median $1,071.52 Typical High $1,819.70 | Facility | None | $851.14 | $1,071.52 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,659.59 | Professional | None | $912.01 | $1,047.13 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $9,549.93 Typical High $11,220.18 | Facility | None | $758.58 | $9,549.93 | $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 50 · Both sides Typical Low $1,412.54 Median $1,698.24 Typical High $2,398.83 | Professional | 50 · Both sides | $1,412.54 | $1,698.24 | $2,398.83 |
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 $977.24 Median $1,621.81 Typical High $5,888.44 | Facility | None | $977.24 | $1,621.81 | $5,888.44 |
CareSource Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,380.38 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $3,890.45 Typical High $4,466.84 | Facility | None | $34.67 | $3,890.45 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $6,606.93 | Professional | None | $1,047.13 | $1,479.11 | $6,606.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $691.83 | Professional | None | $33.11 | $33.11 | $691.83 |
United Setting Facility Modifier None Typical Low $977.24 Median $2,570.40 Typical High $9,549.93 | Facility | None | $977.24 | $2,570.40 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,445.44 | $1,995.26 |
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 $457.09 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $457.09 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $891.25 | Professional | 54 · Surgery only | $691.83 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $831.76 |
Where Kentucky sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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 $14,731KY $2,968
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.