How much rates vary
Facilitymedian $6,761 · 10th to 90th $759 to $75,858Professionalmedian $1,698 · 10th to 90th $1,000 to $2,455
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 $6,760.83 Typical High $35,481.34 | Facility | None | $4,365.16 | $6,760.83 | $35,481.34 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $13,803.84 Typical High $83,176.38 | Facility | None | $6,309.57 | $13,803.84 | $83,176.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,698.24 Typical High $2,290.87 | Professional | None | $933.25 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $1,071.52 Typical High $1,479.11 | Professional | 62 · Two surgeons | $575.44 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $144.54 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $125.89 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $63,095.73 | Facility | None | $512.86 | $1,380.38 | $63,095.73 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
ConnectiCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
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 $977.24 Median $1,548.82 Typical High $3,235.94 | Professional | None | $977.24 | $1,548.82 | $3,235.94 |
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 $512.86 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $776.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $154.88 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $724.44 | $1,071.52 | $1,071.52 |
Where Connecticut sits
The same service costs 11.8 times more in Alabama than in Maryland. 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 $19,042MD $1,609
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.