How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,175 to $21,878Professionalmedian $1,413 · 10th to 90th $832 to $2,138
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | None | $912.01 | $1,318.26 | $1,318.26 |
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 $870.96 Median $1,548.82 Typical High $2,089.30 | Professional | None | $870.96 | $1,548.82 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,290.87 Typical High $3,162.28 | Professional | 50 · Both sides | $1,288.25 | $2,290.87 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $977.24 Typical High $1,318.26 | Professional | 62 · Two surgeons | $537.03 | $977.24 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $245.47 Typical High $338.84 | Professional | 80 · Assistant surgeon | $138.04 | $245.47 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $213.80 Typical High $295.12 | Professional | AS · PA/NP assist | $120.23 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $10,000.00 Typical High $12,302.69 | Facility | None | $1,000.00 | $10,000.00 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,412.54 | $2,041.74 |
ConnectiCare Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,548.82 | Professional | None | $954.99 | $1,288.25 | $1,548.82 |
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 $691.83 Median $1,258.93 Typical High $2,344.23 | Professional | None | $691.83 | $1,258.93 | $2,344.23 |
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 $446.68 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $446.68 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $676.08 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $134.90 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $630.96 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 5.9 times more in Colorado than in Kentucky. 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 $14,720KY $2,476
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.