How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $24,547Professionalmedian $4,266 · 10th to 90th $2,512 to $6,166
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 $2,754.23 Median $4,168.69 Typical High $4,168.69 | Professional | None | $2,754.23 | $4,168.69 | $4,168.69 |
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 $2,454.71 Median $4,265.80 Typical High $5,888.44 | Professional | None | $2,454.71 | $4,265.80 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $2,691.53 Typical High $3,801.89 | Professional | 62 · Two surgeons | $1,445.44 | $2,691.53 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $691.83 Typical High $954.99 | Professional | 80 · Assistant surgeon | $371.54 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $602.56 Typical High $851.14 | Professional | AS · PA/NP assist | $323.59 | $602.56 | $851.14 |
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 $2,818.38 Median $3,715.35 Typical High $6,456.54 | Professional | None | $2,818.38 | $3,715.35 | $6,456.54 |
ConnectiCare Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,168.69 | $4,786.30 |
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 $2,570.40 Median $4,073.80 Typical High $8,709.64 | Professional | None | $2,570.40 | $4,073.80 | $8,709.64 |
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 $1,380.38 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,380.38 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $549.54 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,041.74 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $407.38 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $275.42 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,884.03 | $2,884.03 |
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 $22,023WA $3,113
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.