How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $14,454Professionalmedian $2,884 · 10th to 90th $1,622 to $4,266
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 $1,862.09 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,862.09 | $2,951.21 | $2,951.21 |
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 $1,621.81 Median $2,754.23 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,754.23 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,737.80 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,023.29 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $436.52 Typical High $630.96 | Professional | 80 · Assistant surgeon | $257.04 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $389.05 Typical High $549.54 | Professional | AS · PA/NP assist | $229.09 | $389.05 | $549.54 |
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 $2,089.30 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,089.30 | $2,754.23 | $4,168.69 |
ConnectiCare Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Professional | None | $2,884.03 | $2,884.03 | $3,019.95 |
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 $1,819.70 Median $2,818.38 Typical High $5,754.40 | Professional | None | $1,819.70 | $2,818.38 | $5,754.40 |
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 $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $933.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $380.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,412.54 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $281.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $186.21 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,318.26 | $2,041.74 | $2,041.74 |
Where Connecticut sits
The same service costs 8.3 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 $19,381WA $2,326
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.