How much rates vary
Facilitymedian $6,761 · 10th to 90th $891 to $21,878Professionalmedian $1,479 · 10th to 90th $759 to $2,138
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | None | $851.14 | $1,230.27 | $1,230.27 |
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 $758.58 Median $1,479.11 Typical High $1,995.26 | Professional | None | $758.58 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $933.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $478.63 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $123.03 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $107.15 | $208.93 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,549.93 Typical High $12,022.64 | Facility | None | $1,000.00 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,348.96 | $2,089.30 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,348.96 | $1,445.44 |
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 $660.69 Median $1,230.27 Typical High $2,398.83 | Professional | None | $660.69 | $1,230.27 | $2,398.83 |
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 $426.58 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $169.82 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $630.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $588.84 | $870.96 | $870.96 |
Where Connecticut sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.