How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,445 to $13,804Professionalmedian $1,622 · 10th to 90th $1,096 to $4,571
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 $1,412.54 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,412.54 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,238.72 | Professional | None | $912.01 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $6,918.31 Typical High $13,182.57 | Facility | None | $1,513.56 | $6,918.31 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,398.83 Typical High $3,090.30 | Professional | 50 · Both sides | $1,862.09 | $2,398.83 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,000.00 Typical High $1,318.26 | Professional | 62 · Two surgeons | $776.25 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $257.04 Typical High $331.13 | Professional | 80 · Assistant surgeon | $194.98 | $257.04 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $223.87 Typical High $288.40 | Professional | AS · PA/NP assist | $173.78 | $223.87 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,148.15 | $1,548.82 |
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 $933.25 Median $1,230.27 Typical High $2,187.76 | Professional | None | $933.25 | $1,230.27 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $5,888.44 Typical High $19,952.62 | Facility | None | $1,230.27 | $5,888.44 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $9,772.37 | Professional | None | $1,202.26 | $2,137.96 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $7,079.46 Typical High $12,882.50 | Facility | None | $1,174.90 | $7,079.46 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,819.70 | $2,398.83 |
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 $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $776.25 | $794.33 |
Where Missouri 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.