How much rates vary
Facilitymedian $3,715 · 10th to 90th $776 to $7,943Professionalmedian $724 · 10th to 90th $427 to $1,047
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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $758.58 | Professional | None | $489.78 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $1,000.00 | Professional | None | $436.52 | $794.33 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,174.90 Typical High $1,479.11 | Professional | 50 · Both sides | $660.69 | $1,174.90 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $489.78 Typical High $630.96 | Professional | 62 · Two surgeons | $275.42 | $489.78 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,570.40 Typical High $3,235.94 | Facility | None | $549.54 | $2,570.40 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,071.52 | Professional | None | $416.87 | $645.65 | $1,071.52 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $776.25 | Professional | None | $302.00 | $512.86 | $776.25 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $1,584.89 | Professional | None | $416.87 | $575.44 | $1,584.89 |
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 $281.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $281.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $56.23 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $524.81 | $524.81 |
Where Connecticut sits
The same service costs 3.6 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 $5,056MT $1,400
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.