How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,122 to $24,547Professionalmedian $1,000 · 10th to 90th $550 to $1,479
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 $616.60 Median $912.01 Typical High $912.01 | Professional | None | $616.60 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $22,908.68 Typical High $30,199.52 | Facility | None | $7,585.78 | $22,908.68 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $1,071.52 Typical High $1,479.11 | Professional | None | $549.54 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,584.89 Typical High $2,238.72 | Professional | 50 · Both sides | $794.33 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $660.69 Typical High $933.25 | Professional | 62 · Two surgeons | $338.84 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $85.11 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $74.13 | $147.91 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $19,498.45 Typical High $24,547.09 | Facility | None | $1,000.00 | $19,498.45 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,445.44 | Professional | None | $912.01 | $1,000.00 | $1,445.44 |
ConnectiCare Setting Facility Modifier None Typical Low $645.65 Median $21,877.62 Typical High $21,877.62 | Facility | None | $645.65 | $21,877.62 | $21,877.62 |
ConnectiCare Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,071.52 | Professional | None | $691.83 | $933.25 | $1,071.52 |
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 $478.63 Median $933.25 Typical High $1,621.81 | Professional | None | $478.63 | $933.25 | $1,621.81 |
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 $309.03 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $309.03 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $61.66 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $645.65 | $645.65 |
Where Connecticut sits
The same service costs 10.1 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 $19,890MT $1,977
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.