How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,047 · 10th to 90th $575 to $1,549
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $954.99 | Professional | None | $660.69 | $954.99 | $954.99 |
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 $1,122.02 Typical High $1,548.82 | Professional | None | $575.44 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,659.59 Typical High $2,344.23 | Professional | 50 · Both sides | $870.96 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $173.78 Typical High $245.47 | Professional | 80 · Assistant surgeon | $93.33 | $173.78 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $154.88 Typical High $218.78 | Professional | AS · PA/NP assist | $81.28 | $154.88 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,513.56 | Professional | None | $977.24 | $1,047.13 | $1,513.56 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,122.02 | Professional | None | $707.95 | $954.99 | $1,122.02 |
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 $501.19 Median $933.25 Typical High $1,737.80 | Professional | None | $501.19 | $933.25 | $1,737.80 |
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 $331.13 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 3.7 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 $7,647MT $2,070
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.