How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $24,547Professionalmedian $4,677 · 10th to 90th $2,630 to $6,761
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 $4,466.84 Typical High $4,466.84 | Professional | None | $2,754.23 | $4,466.84 | $4,466.84 |
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 $2,630.27 Median $4,677.35 Typical High $6,309.57 | Professional | None | $2,630.27 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,884.03 Typical High $4,073.80 | Professional | 62 · Two surgeons | $1,584.89 | $2,884.03 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $741.31 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $398.11 | $741.31 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $645.65 Typical High $912.01 | Professional | AS · PA/NP assist | $354.81 | $645.65 | $912.01 |
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 $2,398.83 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,398.83 | $3,981.07 | $6,918.31 |
ConnectiCare Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,128.61 | Professional | None | $4,466.84 | $4,466.84 | $5,128.61 |
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 $2,630.27 Median $4,466.84 Typical High $9,332.54 | Professional | None | $2,630.27 | $4,466.84 | $9,332.54 |
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 $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,479.11 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $588.84 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,238.72 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $446.68 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $295.12 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,089.30 | $3,162.28 | $3,162.28 |
Where Connecticut sits
The same service costs 6.9 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 $22,987WA $3,314
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.