How much rates vary
Facilitymedian $4,266 · 10th to 90th $661 to $24,547Professionalmedian $3,162 · 10th to 90th $1,862 to $4,467
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 $1,905.46 Median $3,019.95 Typical High $3,019.95 | Professional | None | $1,905.46 | $3,019.95 | $3,019.95 |
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 $1,778.28 Median $3,162.28 Typical High $4,265.80 | Professional | None | $1,778.28 | $3,162.28 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,995.26 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,122.02 | $1,995.26 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $501.19 Typical High $707.95 | Professional | 80 · Assistant surgeon | $281.84 | $501.19 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $446.68 Typical High $616.60 | Professional | AS · PA/NP assist | $251.19 | $446.68 | $616.60 |
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 $2,187.76 Median $2,951.21 Typical High $4,677.35 | Professional | None | $2,187.76 | $2,951.21 | $4,677.35 |
ConnectiCare Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,467.37 | Professional | None | $3,019.95 | $3,019.95 | $3,467.37 |
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 $1,905.46 Median $2,951.21 Typical High $6,309.57 | Professional | None | $1,905.46 | $2,951.21 | $6,309.57 |
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 $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,000.00 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $398.11 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,513.56 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $302.00 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $199.53 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,137.96 | $2,137.96 |
Where Connecticut sits
The same service costs 7.9 times more in Alabama 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
AL $20,238WA $2,549
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.