How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,148 to $21,878Professionalmedian $1,698 · 10th to 90th $977 to $2,570
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 $1,096.48 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,584.89 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $16,595.87 Typical High $25,703.96 | Facility | None | $3,715.35 | $16,595.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $2,818.38 Typical High $3,801.89 | Professional | 50 · Both sides | $1,445.44 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $616.60 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $295.12 Typical High $407.38 | Professional | 80 · Assistant surgeon | $154.88 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $134.90 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,412.54 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,737.80 | $2,511.89 |
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 $1,174.90 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,548.82 | $1,862.09 |
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 $831.76 Median $1,548.82 Typical High $2,884.03 | Professional | None | $831.76 | $1,548.82 | $2,884.03 |
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 $549.54 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $218.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $812.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $162.18 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $758.58 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 4.2 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 $14,362MT $3,396
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.