How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $24,547Professionalmedian $2,188 · 10th to 90th $1,445 to $3,467
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 $1,513.56 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,513.56 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,412.54 | $2,238.72 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,380.38 Typical High $2,041.74 | Professional | 62 · Two surgeons | $870.96 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $354.81 Typical High $524.81 | Professional | 80 · Assistant surgeon | $218.78 | $354.81 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $309.03 Typical High $457.09 | Professional | AS · PA/NP assist | $190.55 | $309.03 | $457.09 |
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 $1,862.09 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,862.09 | $2,137.96 | $3,235.94 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,344.23 | $2,691.53 |
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 $1,348.96 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,949.84 | $3,981.07 |
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 $794.33 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $794.33 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $316.23 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,174.90 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $234.42 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $158.49 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,819.70 | $1,819.70 |
Where Connecticut sits
The same service costs 7.8 times more in Colorado than in Washington. 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 $16,544WA $2,120
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.