How much rates vary
Facilitymedian $6,310 · 10th to 90th $891 to $12,303Professionalmedian $2,188 · 10th to 90th $1,288 to $3,162
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 $1,380.38 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,380.38 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,288.25 | $2,187.76 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,380.38 Typical High $1,905.46 | Professional | 62 · Two surgeons | $794.33 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $346.74 Typical High $489.78 | Professional | 80 · Assistant surgeon | $199.53 | $346.74 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $302.00 Typical High $426.58 | Professional | AS · PA/NP assist | $173.78 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,456.54 Typical High $8,128.31 | Facility | None | $851.14 | $6,456.54 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,089.30 | $3,388.44 |
ConnectiCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,398.83 | Professional | None | $2,137.96 | $2,137.96 | $2,398.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $4,570.88 | Professional | None | $1,380.38 | $2,137.96 | $4,570.88 |
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 $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $288.40 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,071.52 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $213.80 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.