How much rates vary
Facilitymedian $2,754 · 10th to 90th $676 to $12,303Professionalmedian $1,950 · 10th to 90th $1,148 to $2,630
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 $1,122.02 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $7,413.10 Typical High $13,489.63 | Facility | None | $1,819.70 | $7,413.10 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,949.84 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,230.27 Typical High $1,659.59 | Professional | 62 · Two surgeons | $645.65 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $309.03 Typical High $426.58 | Professional | 80 · Assistant surgeon | $165.96 | $309.03 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $269.15 Typical High $371.54 | Professional | AS · PA/NP assist | $144.54 | $269.15 | $371.54 |
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 $1,479.11 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,778.28 | $2,754.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,778.28 | $1,778.28 | $2,137.96 |
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 $1,148.15 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,148.15 | $1,778.28 | $3,801.89 |
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 $616.60 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $616.60 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $251.19 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $933.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $125.89 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $870.96 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 9.9 times more in Alabama than in Maryland. 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 $18,241MD $1,851
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.