How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,122 to $13,490Professionalmedian $2,344 · 10th to 90th $1,259 to $3,631
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 $1,548.82 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,548.82 | $2,290.87 | $2,290.87 |
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 $1,380.38 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $3,890.45 Typical High $5,248.07 | Professional | 50 · Both sides | $2,089.30 | $3,890.45 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,621.81 Typical High $2,238.72 | Professional | 62 · Two surgeons | $870.96 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $407.38 Typical High $562.34 | Professional | 80 · Assistant surgeon | $223.87 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $363.08 Typical High $489.78 | Professional | AS · PA/NP assist | $194.98 | $363.08 | $489.78 |
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 $1,258.93 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,778.28 | $3,467.37 |
ConnectiCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,778.28 | $2,454.71 |
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 $933.25 Median $2,089.30 Typical High $4,073.80 | Professional | None | $933.25 | $2,089.30 | $4,073.80 |
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 $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $776.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $309.03 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,148.15 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $229.09 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $154.88 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,584.89 | $1,584.89 |
Where Connecticut sits
The same service costs 5.5 times more in Alaska 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
AK $15,938KY $2,890
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.