How much rates vary
Facilitymedian $4,169 · 10th to 90th $676 to $16,218Professionalmedian $1,995 · 10th to 90th $1,230 to $3,020
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 $3,467.37 Median $5,248.07 Typical High $8,128.31 | Facility | None | $3,467.37 | $5,248.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,258.93 | $2,238.72 | $2,238.72 |
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 $1,202.26 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $288.40 Typical High $436.52 | Professional | 80 · Assistant surgeon | $186.21 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $257.04 Typical High $380.19 | Professional | AS · PA/NP assist | $162.18 | $257.04 | $380.19 |
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 $1,659.59 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,659.59 | $1,862.09 | $2,818.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,905.46 | $2,290.87 |
Health New England Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $1,148.15 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,778.28 | $3,388.44 |
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 $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $660.69 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $269.15 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,000.00 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $199.53 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $131.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $933.25 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 6.3 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 $11,778MD $1,881
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.