How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $16,982Professionalmedian $214 · 10th to 90th $135 to $363
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 $147.91 Median $213.80 Typical High $213.80 | Professional | None | $147.91 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $16,595.87 Typical High $19,952.62 | Facility | None | $1,000.00 | $16,595.87 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $309.03 | Professional | None | $125.89 | $213.80 | $309.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $79.43 Median $134.90 Typical High $194.98 | Professional | 62 · Two surgeons | $79.43 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $34.67 Typical High $48.98 | Professional | 80 · Assistant surgeon | $20.42 | $34.67 | $48.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $30.20 Typical High $42.66 | Professional | AS · PA/NP assist | $17.78 | $30.20 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $4,265.80 | Facility | None | $501.19 | $1,000.00 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $426.58 | Professional | None | $169.82 | $295.12 | $426.58 |
ConnectiCare Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | None | $223.87 | $223.87 | $239.88 |
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 $138.04 Median $257.04 Typical High $446.68 | Professional | None | $138.04 | $257.04 | $446.68 |
5 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 $74.13 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $74.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $109.65 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $22.39 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $21.38 | $21.38 |
Where Connecticut sits
The same service costs 45.5 times more in Alabama 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
AL $17,961MT $395
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.