How much rates vary
Facilitymedian $9,550 · 10th to 90th $1,950 to $21,380Professionalmedian $1,862 · 10th to 90th $1,148 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 $6,760.83 Typical High $10,471.29 | Facility | None | $4,570.88 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,949.84 | $2,238.72 |
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 $1,348.96 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,754.23 Typical High $4,168.69 | Professional | 50 · Both sides | $1,995.26 | $2,754.23 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,174.90 Typical High $1,778.28 | Professional | 62 · Two surgeons | $831.76 | $1,174.90 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $295.12 Typical High $446.68 | Professional | 80 · Assistant surgeon | $213.80 | $295.12 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $257.04 Typical High $389.05 | Professional | AS · PA/NP assist | $186.21 | $257.04 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $7,585.78 Typical High $14,125.38 | Facility | None | $2,187.76 | $7,585.78 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,659.59 | $1,778.28 | $3,235.94 |
ConnectiCare Setting Facility Modifier None Typical Low $10,471.29 Median $13,489.63 Typical High $13,803.84 | Facility | None | $10,471.29 | $13,489.63 | $13,803.84 |
ConnectiCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,659.59 | $1,995.26 |
Health New England Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $912.01 Median $1,621.81 Typical High $3,548.13 | Professional | None | $912.01 | $1,621.81 | $3,548.13 |
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 $660.69 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $660.69 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $263.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $977.24 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $131.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $912.01 | $1,380.38 | $1,380.38 |
Where Connecticut sits
The same service costs 5.0 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 $14,731KY $2,968
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.