How much rates vary
Facilitymedian $4,266 · 10th to 90th $646 to $14,454Professionalmedian $2,089 · 10th to 90th $1,230 to $3,090
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 $1,318.26 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,318.26 | $2,089.30 | $2,089.30 |
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 $1,148.15 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,949.84 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,951.21 Typical High $4,365.16 | Professional | 50 · Both sides | $1,698.24 | $2,951.21 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,230.27 Typical High $1,819.70 | Professional | 62 · Two surgeons | $724.44 | $1,230.27 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $181.97 | $309.03 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $275.42 Typical High $407.38 | Professional | AS · PA/NP assist | $158.49 | $275.42 | $407.38 |
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 $1,479.11 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,041.74 | $3,235.94 |
ConnectiCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | None | $2,089.30 | $2,089.30 | $2,137.96 |
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 $1,318.26 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,318.26 | $2,041.74 | $4,265.80 |
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 $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $660.69 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,000.00 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $199.53 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $131.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $933.25 | $1,445.44 | $1,445.44 |
Where Connecticut sits
The same service costs 6.4 times more in Alaska than in Maryland. 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 $12,091MD $1,881
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.