How much rates vary
Facilitymedian $6,761 · 10th to 90th $871 to $21,878Professionalmedian $1,202 · 10th to 90th $692 to $1,862
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 $6,606.93 Typical High $8,511.38 | Facility | None | $4,570.88 | $6,606.93 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $776.25 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $16,218.10 Typical High $25,703.96 | Facility | None | $3,715.35 | $16,218.10 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,318.26 Typical High $1,819.70 | Professional | None | $691.83 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,949.84 Typical High $2,691.53 | Professional | 50 · Both sides | $1,023.29 | $1,949.84 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $426.58 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $107.15 | $208.93 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $181.97 Typical High $251.19 | Professional | AS · PA/NP assist | $95.50 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,258.93 | $1,737.80 |
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 $831.76 Median $1,122.02 Typical High $1,348.96 | Professional | None | $831.76 | $1,122.02 | $1,348.96 |
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 $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,089.30 | Professional | None | $602.56 | $1,122.02 | $2,089.30 |
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 $389.05 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $389.05 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $77.62 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $549.54 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 4.9 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 $11,762MT $2,377
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.