How much rates vary
Facilitymedian $6,166 · 10th to 90th $871 to $12,303Professionalmedian $1,445 · 10th to 90th $759 to $2,188
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 $870.96 Median $1,258.93 Typical High $1,445.44 | Professional | None | $870.96 | $1,258.93 | $1,445.44 |
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 $758.58 Median $1,479.11 Typical High $2,041.74 | Professional | None | $758.58 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $933.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $478.63 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $120.23 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $204.17 Typical High $288.40 | Professional | AS · PA/NP assist | $107.15 | $204.17 | $288.40 |
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 $1,000.00 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,348.96 | $1,513.56 |
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 $1,288.25 Typical High $2,344.23 | Professional | None | $660.69 | $1,288.25 | $2,344.23 |
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 $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $426.58 | $630.96 | $630.96 |
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 $125.89 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $125.89 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $85.11 | $125.89 | $125.89 |
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 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.