How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,096 to $23,442Professionalmedian $955 · 10th to 90th $525 to $1,413
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | None | $602.56 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $22,908.68 Typical High $28,183.83 | Facility | None | $3,715.35 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $1,023.29 Typical High $1,412.54 | Professional | None | $524.81 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,479.11 Typical High $2,089.30 | Professional | 50 · Both sides | $776.25 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $630.96 Typical High $891.25 | Professional | 62 · Two surgeons | $331.13 | $630.96 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $83.18 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $138.04 Typical High $194.98 | Professional | AS · PA/NP assist | $72.44 | $138.04 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,380.38 | Professional | None | $831.76 | $933.25 | $1,380.38 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,000.00 | Professional | None | $660.69 | $870.96 | $1,000.00 |
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 $457.09 Median $851.14 Typical High $1,584.89 | Professional | None | $457.09 | $851.14 | $1,584.89 |
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 $302.00 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $302.00 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $616.60 | $616.60 |
Where Connecticut sits
The same service costs 7.4 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 $13,995MT $1,888
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.