How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,096 to $12,589Professionalmedian $1,318 · 10th to 90th $794 to $2,089
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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | None | $912.01 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,479.11 Typical High $2,041.74 | Professional | None | $794.33 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $2,238.72 Typical High $3,019.95 | Professional | 50 · Both sides | $1,174.90 | $2,238.72 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $933.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $501.19 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $239.88 Typical High $323.59 | Professional | 80 · Assistant surgeon | $125.89 | $239.88 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $109.65 | $208.93 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,445.44 | $1,949.84 |
ConnectiCare Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,548.82 | Professional | None | $912.01 | $1,288.25 | $1,548.82 |
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 $676.08 Median $1,258.93 Typical High $2,344.23 | Professional | None | $676.08 | $1,258.93 | $2,344.23 |
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 $457.09 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $457.09 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $676.08 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $138.04 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $630.96 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.