How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $14,454Professionalmedian $676 · 10th to 90th $490 to $2,399
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 $1,698.24 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,698.24 | $5,495.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $1,047.13 | Professional | None | $446.68 | $524.81 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,370.32 Typical High $16,982.44 | Facility | None | $1,479.11 | $5,370.32 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,000.00 Typical High $1,445.44 | Professional | 50 · Both sides | $812.83 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $426.58 Typical High $616.60 | Professional | 62 · Two surgeons | $346.74 | $426.58 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $107.15 Typical High $154.88 | Professional | 80 · Assistant surgeon | $87.10 | $107.15 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $93.33 Typical High $134.90 | Professional | AS · PA/NP assist | $75.86 | $93.33 | $134.90 |
BCBS Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $707.95 | Professional | None | $501.19 | $537.03 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $10,471.29 | Facility | None | $741.31 | $2,290.87 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,071.52 | Professional | None | $446.68 | $562.34 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $26,302.68 | Facility | None | $724.44 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $4,265.80 | Professional | None | $537.03 | $891.25 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,096.48 | $3,801.89 | $9,120.11 |
United Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,047.13 | Professional | None | $467.74 | $676.08 | $1,047.13 |
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 $223.87 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $338.84 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $416.87 |
Where Missouri sits
The same service costs 4.5 times more in Connecticut 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
CT $7,632MT $1,703
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.