How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,122 to $19,055Professionalmedian $1,995 · 10th to 90th $1,023 to $2,818
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 $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,489.63 | Facility | None | $933.25 | $11,748.98 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $2,344.23 Typical High $3,019.95 | Professional | None | $1,071.52 | $2,344.23 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $3,548.13 Typical High $4,570.88 | Professional | 50 · Both sides | $1,548.82 | $3,548.13 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,479.11 Typical High $1,905.46 | Professional | 62 · Two surgeons | $645.65 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $380.19 Typical High $489.78 | Professional | 80 · Assistant surgeon | $165.96 | $380.19 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $331.13 Typical High $426.58 | Professional | AS · PA/NP assist | $144.54 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $19,498.45 Typical High $23,988.33 | Facility | None | $851.14 | $19,498.45 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,698.24 | $2,570.40 |
ConnectiCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,621.81 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $2,884.03 | Professional | None | $831.76 | $1,548.82 | $2,884.03 |
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 $549.54 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $831.76 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $165.96 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $776.25 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 6.0 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 $15,585KY $2,601
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.