How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,122 to $13,490Professionalmedian $3,162 · 10th to 90th $1,479 to $5,012
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,137.96 | $3,090.30 | $3,090.30 |
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 $1,905.46 Median $3,548.13 Typical High $4,677.35 | Professional | None | $1,905.46 | $3,548.13 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,818.38 Median $5,248.07 Typical High $7,079.46 | Professional | 50 · Both sides | $2,818.38 | $5,248.07 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $2,187.76 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,202.26 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $562.34 Typical High $758.58 | Professional | 80 · Assistant surgeon | $302.00 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $489.78 Typical High $660.69 | Professional | AS · PA/NP assist | $263.03 | $489.78 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $4,786.30 | Professional | None | $1,412.54 | $2,187.76 | $4,786.30 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,754.23 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $2,884.03 Typical High $5,623.41 | Professional | None | $1,047.13 | $2,884.03 | $5,623.41 |
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 $1,071.52 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,071.52 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,621.81 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $323.59 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,187.76 | $2,187.76 |
Where Connecticut sits
The same service costs 4.9 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 $18,090KY $3,723
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.