How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,023 to $16,596Professionalmedian $813 · 10th to 90th $589 to $1,698
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,288.25 Typical High $1,548.82 | Professional | None | $707.95 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $10,715.19 Typical High $18,197.01 | Facility | None | $6,760.83 | $10,715.19 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,548.82 | Professional | None | $630.96 | $812.83 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,202.26 Typical High $2,187.76 | Professional | 50 · Both sides | $933.25 | $1,202.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $512.86 Typical High $933.25 | Professional | 62 · Two surgeons | $389.05 | $512.86 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $8,128.31 | Facility | None | $741.31 | $6,456.54 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,230.27 Typical High $1,905.46 | Professional | None | $575.44 | $1,230.27 | $1,905.46 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,096.48 Typical High $2,137.96 | Professional | None | $426.58 | $1,096.48 | $2,137.96 |
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 $346.74 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $346.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $138.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $524.81 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $104.71 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $69.18 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $489.78 | $891.25 | $891.25 |
Where Connecticut sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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 $12,924HI $2,150
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.