How much rates vary
Facilitymedian $6,761 · 10th to 90th $851 to $21,878Professionalmedian $977 · 10th to 90th $525 to $1,445
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 $588.84 Median $870.96 Typical High $870.96 | Professional | None | $588.84 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $14,125.38 Typical High $25,703.96 | Facility | None | $3,715.35 | $14,125.38 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,445.44 | Professional | None | $537.03 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,513.56 Typical High $2,187.76 | Professional | 50 · Both sides | $794.33 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $645.65 Typical High $912.01 | Professional | 62 · Two surgeons | $331.13 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $87.10 | $165.96 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $141.25 Typical High $204.17 | Professional | AS · PA/NP assist | $74.13 | $141.25 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $11,220.18 Typical High $13,803.84 | Facility | None | $851.14 | $11,220.18 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,348.96 | Professional | None | $794.33 | $912.01 | $1,348.96 |
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 $707.95 Median $851.14 Typical High $1,000.00 | Professional | None | $707.95 | $851.14 | $1,000.00 |
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 $446.68 Median $831.76 Typical High $1,548.82 | Professional | None | $446.68 | $831.76 | $1,548.82 |
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 $295.12 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $117.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $58.88 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $602.56 | $602.56 |
Where Connecticut sits
The same service costs 5.8 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 $11,046MT $1,910
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.