How much rates vary
Facilitymedian $6,457 · 10th to 90th $891 to $14,454Professionalmedian $2,455 · 10th to 90th $1,445 to $3,890
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 $6,760.83 Typical High $10,471.29 | Facility | None | $4,570.88 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,584.89 | $2,398.83 | $2,398.83 |
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 $1,445.44 Median $2,818.38 Typical High $3,715.35 | Professional | None | $1,445.44 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $4,168.69 Typical High $5,623.41 | Professional | 50 · Both sides | $2,187.76 | $4,168.69 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,737.80 Typical High $2,344.23 | Professional | 62 · Two surgeons | $912.01 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $446.68 Typical High $588.84 | Professional | 80 · Assistant surgeon | $234.42 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $389.05 Typical High $524.81 | Professional | AS · PA/NP assist | $204.17 | $389.05 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $13,803.84 Typical High $17,378.01 | Facility | None | $851.14 | $13,803.84 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,715.35 | Professional | None | $2,187.76 | $2,511.89 | $3,715.35 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,290.87 | $2,818.38 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,258.93 | $2,290.87 | $4,265.80 |
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 $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $831.76 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,230.27 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $245.47 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,659.59 | $1,659.59 |
Where Connecticut sits
The same service costs 6.3 times more in Alaska than in Texas. 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 $16,928TX $2,675
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.