How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $21,878Professionalmedian $1,445 · 10th to 90th $851 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 $4,365.16 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 $870.96 Median $1,288.25 Typical High $1,548.82 | Professional | None | $870.96 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $15,135.61 Typical High $25,703.96 | Facility | None | $3,715.35 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $2,137.96 | Professional | None | $870.96 | $1,548.82 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,238.72 Typical High $3,162.28 | Professional | 50 · Both sides | $1,288.25 | $2,238.72 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $933.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $549.54 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $239.88 Typical High $338.84 | Professional | 80 · Assistant surgeon | $138.04 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $120.23 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,772.37 Typical High $12,302.69 | Facility | None | $851.14 | $9,772.37 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,380.38 | $2,089.30 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $4,365.16 | Facility | None | $512.86 | $676.08 | $4,365.16 |
ConnectiCare Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,479.11 | Professional | None | $977.24 | $1,318.26 | $1,479.11 |
Health New England Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,848.93 | Facility | None | $1,122.02 | $7,943.28 | $15,848.93 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $2,454.71 | Professional | None | $676.08 | $1,258.93 | $2,454.71 |
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 $436.52 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $645.65 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $602.56 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.