How much rates vary
Facilitymedian $11,749 · 10th to 90th $1,413 to $28,840Professionalmedian $1,778 · 10th to 90th $1,047 to $2,754
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 $5,248.07 Median $9,332.54 Typical High $26,302.68 | Facility | None | $5,248.07 | $9,332.54 | $26,302.68 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,698.24 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $13,803.84 Typical High $32,359.37 | Facility | None | $6,760.83 | $13,803.84 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,951.21 Typical High $3,981.07 | Professional | 50 · Both sides | $1,548.82 | $2,951.21 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,230.27 Typical High $1,698.24 | Professional | 62 · Two surgeons | $660.69 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $316.23 Typical High $426.58 | Professional | 80 · Assistant surgeon | $165.96 | $316.23 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $144.54 | $275.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $17,782.79 Typical High $21,877.62 | Facility | None | $851.14 | $17,782.79 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,778.28 | $2,630.27 |
ConnectiCare Setting Facility Modifier None Typical Low $17,378.01 Median $17,378.01 Typical High $17,782.79 | Facility | None | $17,378.01 | $17,378.01 | $17,782.79 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,621.81 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $16,982.44 | Facility | None | $1,122.02 | $7,943.28 | $16,982.44 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $3,019.95 | Professional | None | $891.25 | $1,621.81 | $3,019.95 |
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 $588.84 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $234.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $870.96 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $812.83 | $1,202.26 | $1,202.26 |
Where Connecticut sits
The same service costs 10.4 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 $29,118KY $2,808
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.