How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,950 to $21,878Professionalmedian $2,089 · 10th to 90th $1,318 to $3,388
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 $13,803.84 | Facility | None | $4,570.88 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,348.96 | $2,187.76 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $18,197.01 Typical High $24,547.09 | Facility | None | $8,317.64 | $18,197.01 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,089.30 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,162.28 Typical High $4,677.35 | Professional | 50 · Both sides | $2,290.87 | $3,162.28 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,318.26 Typical High $1,949.84 | Professional | 62 · Two surgeons | $954.99 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $338.84 Typical High $501.19 | Professional | 80 · Assistant surgeon | $245.47 | $338.84 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $295.12 Typical High $436.52 | Professional | AS · PA/NP assist | $213.80 | $295.12 | $436.52 |
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 $1,949.84 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,949.84 | $2,089.30 | $3,630.78 |
ConnectiCare Setting Facility Modifier None Typical Low $7,762.47 Median $11,748.98 Typical High $12,022.64 | Facility | None | $7,762.47 | $11,748.98 | $12,022.64 |
ConnectiCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,862.09 | $2,238.72 |
Health New England Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,630.27 | $2,630.27 |
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 $1,023.29 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,023.29 | $1,819.70 | $3,890.45 |
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 $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,096.48 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $218.78 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $147.91 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,513.56 | $1,513.56 |
Where Connecticut sits
The same service costs 4.7 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 $15,002KY $3,224
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.