How much rates vary
Facilitymedian $6,607 · 10th to 90th $977 to $21,878Professionalmedian $1,738 · 10th to 90th $912 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 $4,365.16 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 $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 $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $2,398.83 | Professional | None | $912.01 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,630.27 Typical High $3,548.13 | Professional | 50 · Both sides | $1,348.96 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $1,096.48 Typical High $1,513.56 | Professional | 62 · Two surgeons | $575.44 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $144.54 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $125.89 | $245.47 | $331.13 |
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 $1,445.44 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,584.89 | $2,511.89 |
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 $1,202.26 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,513.56 | $1,737.80 |
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 $794.33 Median $1,479.11 Typical High $2,818.38 | Professional | None | $794.33 | $1,479.11 | $2,818.38 |
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 $501.19 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $501.19 | $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 $758.58 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $758.58 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $151.36 | $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 $707.95 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $707.95 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 5.1 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 $14,362HI $2,794
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.