How much rates vary
Facilitymedian $6,761 · 10th to 90th $891 to $21,878Professionalmedian $1,738 · 10th to 90th $933 to $2,512
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 $1,000.00 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,479.11 | $1,659.59 |
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 $912.01 Median $1,778.28 Typical High $2,454.71 | Professional | None | $912.01 | $1,778.28 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,630.27 Typical High $3,715.35 | Professional | 50 · Both sides | $1,380.38 | $2,630.27 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $147.91 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $245.47 Typical High $346.74 | Professional | AS · PA/NP assist | $128.82 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,000.00 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,584.89 | $2,454.71 |
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 $1,230.27 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,513.56 | $1,698.24 |
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 $776.25 Median $1,479.11 Typical High $2,818.38 | Professional | None | $776.25 | $1,479.11 | $2,818.38 |
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 $501.19 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $501.19 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $199.53 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $758.58 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $151.36 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $100.00 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $707.95 | $1,023.29 | $1,023.29 |
Where Connecticut sits
The same service costs 3.9 times more in Alaska than in Delaware. 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 $12,209DE $3,093
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.