How much rates vary
Facilitymedian $1,820 · 10th to 90th $525 to $5,623Professionalmedian $468 · 10th to 90th $331 to $1,862
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 $812.83 Median $3,162.28 Typical High $7,762.47 | Facility | None | $812.83 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $575.44 | Professional | None | $295.12 | $346.74 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $630.96 | Professional | None | $354.81 | $446.68 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $281.84 Typical High $389.05 | Professional | 62 · Two surgeons | $223.87 | $281.84 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $79.43 Typical High $102.33 | Professional | 80 · Assistant surgeon | $57.54 | $79.43 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $61.66 Typical High $87.10 | Professional | AS · PA/NP assist | $48.98 | $61.66 | $87.10 |
BCBS Kansas City Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $524.81 | Professional | None | $371.54 | $398.11 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,202.26 Typical High $1,659.59 | Facility | None | $446.68 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $707.95 | Professional | None | $309.03 | $407.38 | $707.95 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,754.23 Typical High $12,022.64 | Facility | None | $691.83 | $2,754.23 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $4,168.69 | Professional | None | $371.54 | $660.69 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $758.58 | Professional | None | $323.59 | $549.54 | $758.58 |
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 $151.36 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $151.36 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $61.66 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $269.15 Typical High $281.84 | Professional | 54 · Surgery only | $229.09 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $45.71 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $30.90 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $213.80 | $251.19 | $263.03 |
Where Missouri sits
The same service costs 4.0 times more in Colorado than in Montana. 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 $4,866MT $1,221
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.