How much rates vary
Facilitymedian $4,786 · 10th to 90th $794 to $11,749Professionalmedian $646 · 10th to 90th $437 to $1,122
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $933.25 | Professional | None | $407.38 | $588.84 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $9,772.37 Typical High $13,489.63 | Facility | None | $4,786.30 | $9,772.37 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $851.14 | Professional | None | $467.74 | $645.65 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $977.24 Typical High $1,288.25 | Professional | 50 · Both sides | $707.95 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $104.71 Typical High $134.90 | Professional | 80 · Assistant surgeon | $75.86 | $104.71 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $91.20 Typical High $120.23 | Professional | AS · PA/NP assist | $66.07 | $91.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,168.69 | Facility | None | $741.31 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,174.90 | Professional | None | $501.19 | $794.33 | $1,174.90 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,047.13 | Professional | None | $549.54 | $831.76 | $1,047.13 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $1,479.11 | Professional | None | $354.81 | $724.44 | $1,479.11 |
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 $257.04 Median $295.12 Typical High $467.74 | Professional | 52 · Reduced service | $257.04 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $117.49 Typical High $186.21 | Professional | 53 · Discontinued | $102.33 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $436.52 Typical High $707.95 | Professional | 54 · Surgery only | $380.19 | $436.52 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $141.25 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $58.88 Typical High $93.33 | Professional | 56 · Pre-op care only | $51.29 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $407.38 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $354.81 | $407.38 | $660.69 |
Where Connecticut sits
The same service costs 4.4 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 $6,451MT $1,460
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.