How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,047 to $14,454Professionalmedian $1,096 · 10th to 90th $646 to $1,622
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,096.48 | Professional | None | $645.65 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $13,182.57 Typical High $16,218.10 | Facility | None | $977.24 | $13,182.57 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,513.56 | Professional | None | $645.65 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $691.83 Typical High $977.24 | Professional | 62 · Two surgeons | $407.38 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $173.78 Typical High $245.47 | Professional | 80 · Assistant surgeon | $102.33 | $173.78 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $154.88 Typical High $213.80 | Professional | AS · PA/NP assist | $91.20 | $154.88 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,456.54 Typical High $8,128.31 | Facility | None | $1,000.00 | $6,456.54 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $933.25 | $1,071.52 | $1,659.59 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $4,168.69 | Facility | None | $630.96 | $870.96 | $4,168.69 |
ConnectiCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,096.48 | $1,202.26 |
Health New England Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $691.83 Median $1,071.52 Typical High $2,290.87 | Professional | None | $691.83 | $1,071.52 | $2,290.87 |
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 $354.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $354.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $537.03 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $107.15 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $501.19 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 5.3 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 $10,556MT $2,002
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.