How much rates vary
Facilitymedian $3,715 · 10th to 90th $776 to $11,749Professionalmedian $1,023 · 10th to 90th $537 to $1,514
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 $616.60 Median $912.01 Typical High $933.25 | Professional | None | $616.60 | $912.01 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $1,445.44 | Professional | None | $549.54 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,548.82 Typical High $2,187.76 | Professional | 50 · Both sides | $812.83 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $645.65 Typical High $912.01 | Professional | 62 · Two surgeons | $338.84 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $87.10 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $75.86 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $3,388.44 | Facility | None | $851.14 | $2,630.27 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,445.44 | Professional | None | $660.69 | $851.14 | $1,445.44 |
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 $691.83 Median $851.14 Typical High $1,023.29 | Professional | None | $691.83 | $851.14 | $1,023.29 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $436.52 Median $870.96 Typical High $1,621.81 | Professional | None | $436.52 | $870.96 | $1,621.81 |
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 $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $125.89 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $478.63 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $95.50 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $446.68 | $645.65 | $645.65 |
Where Connecticut sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,475DE $1,401
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.