How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,175 to $10,000Professionalmedian $1,820 · 10th to 90th $1,202 to $3,388
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 $1,318.26 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,318.26 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,479.11 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $1,202.26 Typical High $2,398.83 | Professional | None | $331.13 | $1,202.26 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $10,964.78 | Facility | None | $1,047.13 | $2,089.30 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,819.70 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,818.38 Typical High $4,786.30 | Professional | 50 · Both sides | $1,949.84 | $2,818.38 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,202.26 Typical High $1,995.26 | Professional | 62 · Two surgeons | $831.76 | $1,202.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $331.13 Typical High $524.81 | Professional | 80 · Assistant surgeon | $208.93 | $331.13 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $263.03 Typical High $446.68 | Professional | AS · PA/NP assist | $181.97 | $263.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,365.16 Typical High $6,025.60 | Facility | None | $1,513.56 | $4,365.16 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $4,466.84 | Professional | None | $1,513.56 | $2,187.76 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $6,760.83 | Professional | None | $1,380.38 | $1,659.59 | $6,760.83 |
Oscar Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,344.23 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,801.89 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,148.15 | $1,949.84 | $3,548.13 |
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 $660.69 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $660.69 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,071.52 |
Where Georgia sits
The same service costs 4.7 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 $15,002KY $3,224
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.