How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,413 to $21,878Professionalmedian $1,950 · 10th to 90th $1,202 to $3,090
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 $7,943.28 Typical High $12,882.50 | Facility | None | $4,570.88 | $7,943.28 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $17,782.79 Typical High $24,547.09 | Facility | None | $7,943.28 | $17,782.79 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,041.74 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,258.93 Typical High $1,778.28 | Professional | 62 · Two surgeons | $954.99 | $1,258.93 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $323.59 Typical High $446.68 | Professional | 80 · Assistant surgeon | $239.88 | $323.59 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $281.84 Typical High $398.11 | Professional | AS · PA/NP assist | $208.93 | $281.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $7,762.47 Typical High $14,125.38 | Facility | None | $2,187.76 | $7,762.47 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,659.59 | $1,778.28 | $3,311.31 |
ConnectiCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,584.89 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,659.59 Typical High $3,630.78 | Professional | None | $933.25 | $1,659.59 | $3,630.78 |
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 $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $676.08 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $269.15 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,000.00 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $199.53 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $933.25 | $1,412.54 | $1,412.54 |
Where Connecticut sits
The same service costs 5.5 times more in Colorado than in West Virginia. 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 $14,842WV $2,709
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.