How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,175 to $23,442Professionalmedian $1,514 · 10th to 90th $912 to $2,399
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 $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $21,877.62 Typical High $26,915.35 | Facility | None | $7,585.78 | $21,877.62 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $2,290.87 | Professional | None | $912.01 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,570.40 Typical High $3,467.37 | Professional | 50 · Both sides | $1,348.96 | $2,570.40 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $1,096.48 Typical High $1,445.44 | Professional | 62 · Two surgeons | $575.44 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $275.42 Typical High $363.08 | Professional | 80 · Assistant surgeon | $144.54 | $275.42 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $125.89 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $9,549.93 Typical High $12,022.64 | Facility | None | $1,412.54 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,621.81 | $2,290.87 |
ConnectiCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,348.96 | $1,621.81 |
ConnectiCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,445.44 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $2,691.53 | Professional | None | $776.25 | $1,479.11 | $2,691.53 |
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 $512.86 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $512.86 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $776.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $724.44 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 4.7 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 $14,563MT $3,098
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.