How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,000 to $12,303Professionalmedian $977 · 10th to 90th $562 to $1,445
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 $7,585.78 Typical High $12,882.50 | Facility | None | $4,570.88 | $7,585.78 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $933.25 | Professional | None | $602.56 | $870.96 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,445.44 | Professional | None | $575.44 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,548.82 Typical High $2,187.76 | Professional | 50 · Both sides | $870.96 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $645.65 Typical High $912.01 | Professional | 62 · Two surgeons | $363.08 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $162.18 Typical High $234.42 | Professional | 80 · Assistant surgeon | $93.33 | $162.18 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $81.28 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,467.37 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,380.38 | Professional | None | $812.83 | $933.25 | $1,380.38 |
ConnectiCare Setting Facility Modifier None Typical Low $954.99 Median $6,165.95 Typical High $6,309.57 | Facility | None | $954.99 | $6,165.95 | $6,309.57 |
ConnectiCare Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,000.00 | Professional | None | $676.08 | $870.96 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $1,584.89 | Professional | None | $457.09 | $851.14 | $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 $302.00 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $302.00 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $60.26 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $616.60 | $616.60 |
Where Connecticut sits
The same service costs 3.9 times more in Wisconsin 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
WI $7,471MT $1,932
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.