How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,349 to $20,893Professionalmedian $1,318 · 10th to 90th $912 to $2,138
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 $5,248.07 Median $9,332.54 Typical High $12,882.50 | Facility | None | $5,248.07 | $9,332.54 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $891.25 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $17,782.79 Typical High $27,542.29 | Facility | None | $7,762.47 | $17,782.79 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $1,995.26 | Professional | None | $851.14 | $1,348.96 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $831.76 Typical High $1,258.93 | Professional | 62 · Two surgeons | $537.03 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $208.93 Typical High $323.59 | Professional | 80 · Assistant surgeon | $138.04 | $208.93 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $186.21 Typical High $281.84 | Professional | AS · PA/NP assist | $120.23 | $186.21 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $6,456.54 Typical High $8,317.64 | Facility | None | $1,905.46 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,479.11 | $1,995.26 |
ConnectiCare Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,348.96 | $1,862.09 | $2,187.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Health New England Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $15,848.93 | Facility | None | $8,317.64 | $8,317.64 | $15,848.93 |
Health New England Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $933.25 Median $1,288.25 Typical High $2,754.23 | Professional | None | $933.25 | $1,288.25 | $2,754.23 |
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 $436.52 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $173.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $660.69 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $131.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $87.10 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $616.60 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 4.2 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 $11,551MT $2,762
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.