How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $23,442Professionalmedian $1,096 · 10th to 90th $646 to $1,622
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 $691.83 Median $1,000.00 Typical High $1,047.13 | Professional | None | $691.83 | $1,000.00 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $22,387.21 Typical High $26,915.35 | Facility | None | $7,585.78 | $22,387.21 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $1,621.81 | Professional | None | $645.65 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,698.24 Typical High $2,398.83 | Professional | 50 · Both sides | $954.99 | $1,698.24 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $407.38 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $181.97 Typical High $257.04 | Professional | 80 · Assistant surgeon | $102.33 | $181.97 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $162.18 Typical High $223.87 | Professional | AS · PA/NP assist | $93.33 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,549.93 Typical High $11,748.98 | Facility | None | $851.14 | $9,549.93 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,071.52 | $1,584.89 |
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 $645.65 Median $1,023.29 Typical High $1,148.15 | Professional | None | $645.65 | $1,023.29 | $1,148.15 |
Health New England Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $524.81 Median $977.24 Typical High $1,778.28 | Professional | None | $524.81 | $977.24 | $1,778.28 |
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 $346.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $478.63 | $707.95 | $707.95 |
Where Connecticut sits
The same service costs 6.4 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 $13,816MT $2,168
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.