How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,122 to $15,136Professionalmedian $1,549 · 10th to 90th $955 to $2,291
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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $1,548.82 | Professional | None | $912.01 | $1,548.82 | $1,548.82 |
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 $891.25 Median $1,513.56 Typical High $2,187.76 | Professional | None | $891.25 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,290.87 Typical High $3,235.94 | Professional | 50 · Both sides | $1,348.96 | $2,290.87 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $954.99 Typical High $1,380.38 | Professional | 62 · Two surgeons | $562.34 | $954.99 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $245.47 Typical High $346.74 | Professional | 80 · Assistant surgeon | $144.54 | $245.47 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $213.80 Typical High $302.00 | Professional | AS · PA/NP assist | $125.89 | $213.80 | $302.00 |
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 $1,122.02 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,548.82 | $2,344.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,548.82 | $1,548.82 | $1,698.24 |
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 $954.99 Median $1,513.56 Typical High $3,235.94 | Professional | None | $954.99 | $1,513.56 | $3,235.94 |
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 $501.19 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $501.19 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $199.53 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $758.58 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $100.00 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $707.95 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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 $11,128KY $2,365
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.