How much rates vary
Facilitymedian $5,623 · 10th to 90th $813 to $21,878Professionalmedian $776 · 10th to 90th $437 to $1,175
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $851.14 | Professional | None | $489.78 | $707.95 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $10,000.00 Typical High $25,703.96 | Facility | None | $4,786.30 | $10,000.00 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $1,148.15 | Professional | None | $426.58 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $524.81 Typical High $724.44 | Professional | 62 · Two surgeons | $269.15 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $67.61 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $58.88 | $117.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $7,585.78 Typical High $9,332.54 | Facility | None | $741.31 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,096.48 | Professional | None | $724.44 | $794.33 | $1,096.48 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $851.14 | Professional | None | $524.81 | $724.44 | $851.14 |
Health New England Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $371.54 Median $724.44 Typical High $1,258.93 | Professional | None | $371.54 | $724.44 | $1,258.93 |
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 $245.47 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $97.72 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $363.08 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $338.84 | $501.19 | $501.19 |
Where Connecticut sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.