How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,445 to $30,903Professionalmedian $2,818 · 10th to 90th $1,660 to $4,365
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 $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $30,902.95 Typical High $36,307.81 | Facility | None | $2,137.96 | $30,902.95 | $36,307.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $4,073.80 | Professional | None | $1,659.59 | $3,090.30 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $4,570.88 Typical High $6,165.95 | Professional | 50 · Both sides | $2,454.71 | $4,570.88 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $489.78 Typical High $660.69 | Professional | 80 · Assistant surgeon | $263.03 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $229.09 | $426.58 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $24,547.09 Typical High $30,902.95 | Facility | None | $851.14 | $24,547.09 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $4,073.80 | Professional | None | $2,570.40 | $2,884.03 | $4,073.80 |
ConnectiCare Setting Facility Modifier None Typical Low $28,840.32 Median $28,840.32 Typical High $28,840.32 | Facility | None | $28,840.32 | $28,840.32 | $28,840.32 |
ConnectiCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,949.84 | $2,570.40 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $10,471.29 Typical High $18,197.01 | Facility | None | $1,348.96 | $10,471.29 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $4,786.30 | Professional | None | $1,380.38 | $2,630.27 | $4,786.30 |
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 $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $912.01 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $371.54 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,380.38 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $275.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $181.97 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,862.09 | $1,862.09 |
Where Connecticut sits
The same service costs 7.8 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 $31,233KY $3,989
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.