How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,122 to $15,849Professionalmedian $1,072 · 10th to 90th $603 to $1,660
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 $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $954.99 | Professional | None | $630.96 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $15,135.61 Typical High $17,782.79 | Facility | None | $3,235.94 | $15,135.61 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $1,258.93 Typical High $1,698.24 | Professional | None | $588.84 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $794.33 Typical High $1,071.52 | Professional | 62 · Two surgeons | $371.54 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $199.53 Typical High $269.15 | Professional | 80 · Assistant surgeon | $93.33 | $199.53 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $177.83 Typical High $234.42 | Professional | AS · PA/NP assist | $81.28 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,412.54 | Professional | None | $776.25 | $870.96 | $1,412.54 |
ConnectiCare Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,047.13 | Professional | None | $758.58 | $954.99 | $1,047.13 |
Health New England Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $2,238.72 | Professional | None | $575.44 | $1,000.00 | $2,238.72 |
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 $309.03 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $93.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $61.66 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $436.52 | $660.69 | $660.69 |
Where Connecticut sits
The same service costs 5.4 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 $11,084MT $2,070
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.