How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,175 to $21,878Professionalmedian $3,981 · 10th to 90th $2,239 to $5,888
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 $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $3,715.35 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,715.35 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $5,888.44 | Professional | None | $2,290.87 | $4,168.69 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $2,630.27 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,412.54 | $2,630.27 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $660.69 Typical High $954.99 | Professional | 80 · Assistant surgeon | $354.81 | $660.69 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $588.84 Typical High $831.76 | Professional | AS · PA/NP assist | $316.23 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,548.13 Typical High $5,754.40 | Professional | None | $3,090.30 | $3,548.13 | $5,754.40 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $4,073.80 | Professional | None | $2,344.23 | $3,388.44 | $4,073.80 |
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 $1,905.46 Median $3,467.37 Typical High $6,606.93 | Professional | None | $1,905.46 | $3,467.37 | $6,606.93 |
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 $1,288.25 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,288.25 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $524.81 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,949.84 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $389.05 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $263.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,630.27 | $2,630.27 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Texas. 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
AK $19,772TX $4,915
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.