How much rates vary
Facilitymedian $7,079 · 10th to 90th $871 to $23,442Professionalmedian $741 · 10th to 90th $447 to $1,202
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $933.25 | Professional | None | $457.09 | $630.96 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $21,877.62 Typical High $28,183.83 | Facility | None | $7,585.78 | $21,877.62 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $977.24 | Professional | None | $524.81 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,047.13 Typical High $1,479.11 | Professional | 50 · Both sides | $776.25 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $446.68 Typical High $616.60 | Professional | 62 · Two surgeons | $331.13 | $446.68 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $112.20 Typical High $158.49 | Professional | 80 · Assistant surgeon | $83.18 | $112.20 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $97.72 Typical High $138.04 | Professional | AS · PA/NP assist | $72.44 | $97.72 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,000.00 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,412.54 | Professional | None | $602.56 | $758.58 | $1,412.54 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,071.52 | Professional | None | $741.31 | $870.96 | $1,071.52 |
Health New England Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
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 $1,621.81 | Professional | None | $354.81 | $724.44 | $1,621.81 |
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 $281.84 Median $302.00 Typical High $467.74 | Professional | 52 · Reduced service | $281.84 | $302.00 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $186.21 | Professional | 53 · Discontinued | $112.20 | $120.23 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $707.95 | Professional | 54 · Surgery only | $416.87 | $457.09 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $141.25 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $93.33 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $660.69 |
Where Connecticut sits
The same service costs 6.5 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 $9,949MT $1,532
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.