How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $11,749Professionalmedian $1,318 · 10th to 90th $759 to $1,995
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 $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | None | $831.76 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,481.54 Typical High $13,489.63 | Facility | None | $2,754.23 | $11,481.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,412.54 Typical High $1,949.84 | Professional | None | $794.33 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $2,137.96 Typical High $2,951.21 | Professional | 50 · Both sides | $1,202.26 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $501.19 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $229.09 Typical High $316.23 | Professional | 80 · Assistant surgeon | $125.89 | $229.09 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $199.53 Typical High $275.42 | Professional | AS · PA/NP assist | $112.20 | $199.53 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,388.44 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,258.93 | $1,905.46 |
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 $912.01 Median $1,148.15 Typical High $1,412.54 | Professional | None | $912.01 | $1,148.15 | $1,412.54 |
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 $630.96 Median $1,174.90 Typical High $2,187.76 | Professional | None | $630.96 | $1,174.90 | $2,187.76 |
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 $416.87 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $416.87 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $616.60 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $575.44 | $851.14 | $851.14 |
Where Connecticut sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.