How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $16,218Professionalmedian $1,445 · 10th to 90th $955 to $2,239
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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $15,848.93 Typical High $18,620.87 | Facility | None | $1,122.02 | $15,848.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,089.30 | Professional | None | $954.99 | $1,445.44 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $891.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $602.56 | $891.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $223.87 Typical High $338.84 | Professional | 80 · Assistant surgeon | $151.36 | $223.87 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | AS · PA/NP assist | $131.83 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,380.38 | $2,089.30 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $2,511.89 | Professional | None | $851.14 | $1,258.93 | $2,511.89 |
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 $501.19 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $501.19 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $199.53 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $758.58 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $151.36 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $100.00 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $707.95 | $1,174.90 | $1,174.90 |
Where Connecticut sits
The same service costs 6.9 times more in Colorado than in Maryland. 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 $11,121MD $1,609
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.