How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,202 to $20,417Professionalmedian $1,698 · 10th to 90th $1,148 to $2,818
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 $4,570.88 Median $8,511.38 Typical High $13,489.63 | Facility | None | $4,570.88 | $8,511.38 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $14,125.38 Typical High $26,915.35 | Facility | None | $8,128.31 | $14,125.38 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,737.80 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,096.48 Typical High $1,737.80 | Professional | 62 · Two surgeons | $676.08 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $275.42 Typical High $436.52 | Professional | 80 · Assistant surgeon | $169.82 | $275.42 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $239.88 Typical High $389.05 | Professional | AS · PA/NP assist | $147.91 | $239.88 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,606.93 Typical High $8,317.64 | Facility | None | $851.14 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,548.82 | $1,905.46 | $2,511.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,995.26 | $2,089.30 | $2,089.30 |
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 $1,202.26 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,659.59 | $3,467.37 |
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 $562.34 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $562.34 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $229.09 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $851.14 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $169.82 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $112.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $794.33 | $1,148.15 | $1,148.15 |
Where Connecticut sits
The same service costs 6.3 times more in Colorado than in Kentucky. 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 $15,188KY $2,413
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.