How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,047 to $15,136Professionalmedian $1,000 · 10th to 90th $575 to $1,514
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 $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | None | $645.65 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,412.54 | Professional | None | $575.44 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,479.11 Typical High $2,137.96 | Professional | 50 · Both sides | $870.96 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $616.60 Typical High $891.25 | Professional | 62 · Two surgeons | $363.08 | $616.60 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $93.33 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $81.28 | $138.04 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,456.54 Typical High $8,128.31 | Facility | None | $851.14 | $6,456.54 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,513.56 | Professional | None | $707.95 | $977.24 | $1,513.56 |
ConnectiCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,023.29 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $2,041.74 | Professional | None | $616.60 | $977.24 | $2,041.74 |
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 $323.59 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $128.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $489.78 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $97.72 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $457.09 | $691.83 | $691.83 |
Where Connecticut sits
The same service costs 5.6 times more in Wisconsin than in Montana. 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
WI $10,313MT $1,845
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.