How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $21,878Professionalmedian $1,175 · 10th to 90th $676 to $1,820
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | None | $741.31 | $1,096.48 | $1,096.48 |
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 $676.08 Median $1,288.25 Typical High $1,737.80 | Professional | None | $676.08 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,000.00 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $812.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $416.87 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $107.15 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $177.83 Typical High $245.47 | Professional | AS · PA/NP assist | $93.33 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $10,715.19 Typical High $13,182.57 | Facility | None | $1,000.00 | $10,715.19 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,174.90 | $1,698.24 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,288.25 | Professional | None | $794.33 | $1,071.52 | $1,288.25 |
Health New England Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $575.44 Median $1,122.02 Typical High $1,949.84 | Professional | None | $575.44 | $1,122.02 | $1,949.84 |
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 $371.54 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $371.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $151.36 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $562.34 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $112.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $74.13 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $524.81 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 6.2 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 $14,513MT $2,350
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.