How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $21,878Professionalmedian $1,023 · 10th to 90th $575 to $1,549
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 $645.65 Median $933.25 Typical High $1,000.00 | Professional | None | $645.65 | $933.25 | $1,000.00 |
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 $562.34 Median $1,096.48 Typical High $1,513.56 | Professional | None | $562.34 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,621.81 Typical High $2,238.72 | Professional | 50 · Both sides | $831.76 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $676.08 Typical High $954.99 | Professional | 62 · Two surgeons | $354.81 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $89.13 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $151.36 Typical High $208.93 | Professional | AS · PA/NP assist | $77.62 | $151.36 | $208.93 |
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 $954.99 Median $1,000.00 Typical High $1,479.11 | Professional | None | $954.99 | $1,000.00 | $1,479.11 |
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 $707.95 Median $954.99 Typical High $1,071.52 | Professional | None | $707.95 | $954.99 | $1,071.52 |
Health New England Setting Professional Modifier None Typical Low $478.63 Median $954.99 Typical High $5,754.40 | Professional | None | $478.63 | $954.99 | $5,754.40 |
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 $489.78 Median $954.99 Typical High $1,698.24 | Professional | None | $489.78 | $954.99 | $1,698.24 |
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 $316.23 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $316.23 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $478.63 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $95.50 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $64.57 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $446.68 | $660.69 | $660.69 |
Where Connecticut sits
The same service costs 6.8 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 $13,753MT $2,023
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.