How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $21,878Professionalmedian $1,148 · 10th to 90th $661 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 $4,365.16 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 $707.95 Median $1,071.52 Typical High $1,096.48 | Professional | None | $707.95 | $1,071.52 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $16,595.87 Typical High $25,703.96 | Facility | None | $3,715.35 | $16,595.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,258.93 Typical High $1,698.24 | Professional | None | $660.69 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,905.46 Typical High $2,570.40 | Professional | 50 · Both sides | $977.24 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $794.33 Typical High $1,071.52 | Professional | 62 · Two surgeons | $407.38 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $104.71 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $91.20 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,000.00 Typical High $12,302.69 | Facility | None | $851.14 | $10,000.00 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,148.15 | $1,698.24 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $4,897.79 | Facility | None | $512.86 | $707.95 | $4,897.79 |
ConnectiCare Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,258.93 | Professional | None | $794.33 | $1,047.13 | $1,258.93 |
Health New England Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Health New England Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Professional | None | $741.31 | $741.31 | $1,122.02 |
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 $549.54 Median $1,023.29 Typical High $1,995.26 | Professional | None | $549.54 | $1,023.29 | $1,995.26 |
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 $363.08 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $363.08 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $147.91 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $741.31 | $741.31 |
Where Connecticut sits
The same service costs 6.1 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 $13,882MT $2,270
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.