How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $24,547Professionalmedian $4,074 · 10th to 90th $2,042 to $5,888
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 $2,454.71 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,454.71 | $3,981.07 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $4,073.80 Typical High $5,495.41 | Professional | None | $2,344.23 | $4,073.80 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $2,570.40 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,412.54 | $2,570.40 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $660.69 Typical High $912.01 | Professional | 80 · Assistant surgeon | $354.81 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $575.44 Typical High $776.25 | Professional | AS · PA/NP assist | $309.03 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $3,548.13 Typical High $6,165.95 | Professional | None | $1,548.82 | $3,548.13 | $6,165.95 |
ConnectiCare Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,570.88 | Professional | None | $3,981.07 | $3,981.07 | $4,570.88 |
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 $2,187.76 Median $3,890.45 Typical High $8,317.64 | Professional | None | $2,187.76 | $3,890.45 | $8,317.64 |
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 $1,318.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,318.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $524.81 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,995.26 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $398.11 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $263.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,818.38 | $2,818.38 |
Where Connecticut sits
The same service costs 7.1 times more in Alaska than in Washington. 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
AK $21,795WA $3,089
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.