How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $20,893Professionalmedian $891 · 10th to 90th $501 to $1,349
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 $6,760.83 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,760.83 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $812.83 | Professional | None | $549.54 | $812.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $13,803.84 Typical High $25,703.96 | Facility | None | $6,456.54 | $13,803.84 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,348.96 | Professional | None | $501.19 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,445.44 Typical High $1,995.26 | Professional | 50 · Both sides | $741.31 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $154.88 Typical High $213.80 | Professional | 80 · Assistant surgeon | $79.43 | $154.88 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $134.90 Typical High $186.21 | Professional | AS · PA/NP assist | $69.18 | $134.90 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,288.25 | Professional | None | $794.33 | $870.96 | $1,288.25 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $3,467.37 | Facility | None | $512.86 | $676.08 | $3,467.37 |
ConnectiCare Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $954.99 | Professional | None | $616.60 | $831.76 | $954.99 |
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 $426.58 Median $794.33 Typical High $1,479.11 | Professional | None | $426.58 | $794.33 | $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 $269.15 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $575.44 | $575.44 |
Where Connecticut sits
The same service costs 7.9 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 $13,941MT $1,762
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.