How much rates vary
Facilitymedian $4,074 · 10th to 90th $776 to $7,943Professionalmedian $275 · 10th to 90th $200 to $447
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 $194.98 Median $269.15 Typical High $281.84 | Professional | None | $194.98 | $269.15 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $416.87 | Professional | None | $190.55 | $295.12 | $416.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $120.23 Median $181.97 Typical High $263.03 | Professional | 62 · Two surgeons | $120.23 | $181.97 | $263.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $45.71 Typical High $67.61 | Professional | 80 · Assistant surgeon | $30.90 | $45.71 | $67.61 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $39.81 Typical High $58.88 | Professional | AS · PA/NP assist | $26.92 | $39.81 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,548.13 Typical High $4,466.84 | Facility | None | $549.54 | $3,548.13 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $309.03 Typical High $446.68 | Professional | None | $251.19 | $309.03 | $446.68 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $3,467.37 | Facility | None | $331.13 | $457.09 | $3,467.37 |
ConnectiCare Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | None | $338.84 | $338.84 | $363.08 |
Health New England Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $575.44 | Professional | None | $204.17 | $281.84 | $575.44 |
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 $95.50 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $95.50 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $28.84 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.05 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $190.55 |
Where Connecticut sits
The same service costs 7.6 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 $4,667MT $611
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.