How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,148 to $17,783Professionalmedian $1,318 · 10th to 90th $759 to $2,042
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 $4,570.88 Median $8,128.31 Typical High $12,882.50 | Facility | None | $4,570.88 | $8,128.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,258.93 | Professional | None | $851.14 | $1,230.27 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $15,135.61 Typical High $25,703.96 | Facility | None | $7,585.78 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,995.26 | Professional | None | $776.25 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $2,137.96 Typical High $2,951.21 | Professional | 50 · Both sides | $1,148.15 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $912.01 Typical High $1,258.93 | Professional | 62 · Two surgeons | $467.74 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $229.09 Typical High $316.23 | Professional | 80 · Assistant surgeon | $120.23 | $229.09 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $194.98 Typical High $275.42 | Professional | AS · PA/NP assist | $104.71 | $194.98 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,000.00 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,318.26 | $1,905.46 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $1,000.00 Typical High $3,801.89 | Facility | None | $724.44 | $1,000.00 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,445.44 | Professional | None | $912.01 | $1,230.27 | $1,445.44 |
Health New England Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $645.65 Median $1,258.93 Typical High $2,187.76 | Professional | None | $645.65 | $1,258.93 | $2,187.76 |
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 $426.58 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $169.82 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $630.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $125.89 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $588.84 | $870.96 | $870.96 |
Where Connecticut sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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 $14,031WV $2,390
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.