How much rates vary
Facilitymedian $3,388 · 10th to 90th $912 to $6,918Professionalmedian $186 · 10th to 90th $89 to $363
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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $173.78 Typical High $257.04 | Professional | None | $87.10 | $173.78 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $186.21 Typical High $363.08 | Professional | None | $100.00 | $186.21 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $275.42 Typical High $549.54 | Professional | 50 · Both sides | $151.36 | $275.42 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $14.79 Median $32.36 Typical High $57.54 | Professional | 80 · Assistant surgeon | $14.79 | $32.36 | $57.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $25.70 Typical High $51.29 | Professional | AS · PA/NP assist | $14.13 | $25.70 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,570.40 Typical High $3,388.44 | Facility | None | $851.14 | $2,570.40 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $389.05 | Professional | None | $123.03 | $269.15 | $389.05 |
ConnectiCare Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | None | $269.15 | $269.15 | $354.81 |
Health New England Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Health New England Setting Professional Modifier None Typical Low $77.62 Median $323.59 Typical High $323.59 | Professional | None | $77.62 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $407.38 | Professional | None | $79.43 | $181.97 | $407.38 |
5 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 $47.86 Median $58.88 Typical High $120.23 | Professional | 52 · Reduced service | $47.86 | $58.88 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.44 Typical High $47.86 | Professional | 53 · Discontinued | $19.05 | $23.44 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $87.10 Typical High $181.97 | Professional | 54 · Surgery only | $72.44 | $87.10 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.38 Typical High $36.31 | Professional | 55 · Aftercare only | $14.45 | $17.38 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $23.99 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $23.99 |
Where Connecticut sits
The same service costs 9.7 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 $4,351MT $447
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.