How much rates vary
Facilitymedian $7,413 · 10th to 90th $891 to $12,882Professionalmedian $1,047 · 10th to 90th $603 to $1,622
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 $660.69 Median $954.99 Typical High $1,174.90 | Professional | None | $660.69 | $954.99 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,748.98 Typical High $13,803.84 | Facility | None | $2,754.23 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $1,584.89 | Professional | None | $602.56 | $1,148.15 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,698.24 Typical High $2,344.23 | Professional | 50 · Both sides | $891.25 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $707.95 Typical High $1,000.00 | Professional | 62 · Two surgeons | $371.54 | $707.95 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $199.53 Typical High $251.19 | Professional | 80 · Assistant surgeon | $91.20 | $199.53 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $147.91 Typical High $218.78 | Professional | AS · PA/NP assist | $79.43 | $147.91 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $11,220.18 Typical High $14,125.38 | Facility | None | $1,000.00 | $11,220.18 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,513.56 | Professional | None | $933.25 | $1,023.29 | $1,513.56 |
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 $724.44 Median $977.24 Typical High $1,122.02 | Professional | None | $724.44 | $977.24 | $1,122.02 |
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 $501.19 Median $933.25 Typical High $1,737.80 | Professional | None | $501.19 | $933.25 | $1,737.80 |
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 $331.13 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.