How much rates vary
Facilitymedian $4,571 · 10th to 90th $676 to $33,113Professionalmedian $7,413 · 10th to 90th $4,266 to $11,749
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 $3,801.89 Median $8,912.51 Typical High $8,912.51 | Professional | None | $3,801.89 | $8,912.51 | $8,912.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $30,902.95 Typical High $36,307.81 | Facility | None | $2,137.96 | $30,902.95 | $36,307.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,677.35 Median $7,413.10 Typical High $10,964.78 | Professional | None | $4,677.35 | $7,413.10 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,951.21 Median $4,570.88 Typical High $6,918.31 | Professional | 62 · Two surgeons | $2,951.21 | $4,570.88 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $741.31 Median $1,148.15 Typical High $1,737.80 | Professional | 80 · Assistant surgeon | $741.31 | $1,148.15 | $1,737.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $645.65 Median $1,000.00 Typical High $1,548.82 | Professional | AS · PA/NP assist | $645.65 | $1,000.00 | $1,548.82 |
ConnectiCare Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $8,912.51 | Professional | None | $5,495.41 | $5,495.41 | $8,912.51 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $6,309.57 Typical High $13,489.63 | Professional | None | $3,715.35 | $6,309.57 | $13,489.63 |
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 $2,570.40 Median $4,466.84 Typical High $4,466.84 | Professional | 52 · Reduced service | $2,570.40 | $4,466.84 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,778.28 Typical High $1,778.28 | Professional | 53 · Discontinued | $1,023.29 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $6,606.93 Typical High $6,606.93 | Professional | 54 · Surgery only | $3,801.89 | $6,606.93 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $758.58 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | 56 · Pre-op care only | $512.86 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $6,165.95 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $3,548.13 | $6,165.95 | $6,165.95 |
Where Connecticut sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.