How much rates vary
Facilitymedian $5,754 · 10th to 90th $871 to $12,303Professionalmedian $977 · 10th to 90th $562 to $1,585
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 $6,760.83 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,760.83 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $977.24 | Professional | None | $660.69 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $11,481.54 Typical High $13,803.84 | Facility | None | $6,309.57 | $11,481.54 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,548.82 | Professional | None | $575.44 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,584.89 Typical High $2,290.87 | Professional | 50 · Both sides | $851.14 | $1,584.89 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $660.69 Typical High $977.24 | Professional | 62 · Two surgeons | $363.08 | $660.69 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $91.20 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $151.36 Typical High $213.80 | Professional | AS · PA/NP assist | $81.28 | $151.36 | $213.80 |
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 $912.01 Median $1,047.13 Typical High $1,380.38 | Professional | None | $912.01 | $1,047.13 | $1,380.38 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,148.15 | Professional | None | $660.69 | $1,000.00 | $1,148.15 |
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 $478.63 Median $912.01 Typical High $1,698.24 | Professional | None | $478.63 | $912.01 | $1,698.24 |
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 $331.13 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $131.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $501.19 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $100.00 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $66.07 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $467.74 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.