How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,175 to $15,849Professionalmedian $1,549 · 10th to 90th $912 to $2,344
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 $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,000.00 | $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 $912.01 Median $1,548.82 Typical High $2,238.72 | Professional | None | $912.01 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $977.24 Typical High $1,412.54 | Professional | 62 · Two surgeons | $575.44 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $245.47 Typical High $354.81 | Professional | 80 · Assistant surgeon | $144.54 | $245.47 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $213.80 Typical High $309.03 | Professional | AS · PA/NP assist | $125.89 | $213.80 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $6,760.83 Typical High $8,317.64 | Facility | None | $1,905.46 | $6,760.83 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,548.82 | $2,344.23 |
ConnectiCare Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,348.96 | $1,862.09 | $2,187.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,584.89 | $1,584.89 | $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 $977.24 Median $1,548.82 Typical High $3,235.94 | Professional | None | $977.24 | $1,548.82 | $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 $512.86 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $512.86 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $204.17 | $316.23 | $316.23 |
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 $154.88 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $102.33 | $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 4.0 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 $11,674MT $2,925
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.