How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $14,454Professionalmedian $2,692 · 10th to 90th $1,585 to $3,981
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 $1,737.80 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $12,589.25 Typical High $16,218.10 | Facility | None | $3,630.78 | $12,589.25 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,548.82 | $2,691.53 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,981.07 Typical High $5,623.41 | Professional | 50 · Both sides | $2,344.23 | $3,981.07 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,698.24 Typical High $2,344.23 | Professional | 62 · Two surgeons | $977.24 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $426.58 Typical High $602.56 | Professional | 80 · Assistant surgeon | $251.19 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $371.54 Typical High $524.81 | Professional | AS · PA/NP assist | $218.78 | $371.54 | $524.81 |
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 $1,905.46 Median $2,630.27 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,630.27 | $4,073.80 |
ConnectiCare Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,691.53 | $2,951.21 |
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 $1,698.24 Median $2,630.27 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,630.27 | $5,495.41 |
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 $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $870.96 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $354.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,318.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $263.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $173.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,862.09 | $1,862.09 |
Where Connecticut sits
The same service costs 8.2 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 $19,170WA $2,342
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.