How much rates vary
Facilitymedian $3,715 · 10th to 90th $676 to $7,943Professionalmedian $2,042 · 10th to 90th $1,148 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 $1,174.90 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $7,079.46 | Facility | None | $2,754.23 | $4,168.69 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,148.15 | $2,398.83 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,513.56 Typical High $1,995.26 | Professional | 62 · Two surgeons | $724.44 | $1,513.56 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $380.19 Typical High $512.86 | Professional | 80 · Assistant surgeon | $186.21 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $331.13 Typical High $446.68 | Professional | AS · PA/NP assist | $162.18 | $331.13 | $446.68 |
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 $1,445.44 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,659.59 | $2,691.53 |
ConnectiCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,778.28 | $1,949.84 |
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 $1,071.52 Median $1,819.70 Typical High $4,265.80 | Professional | None | $1,071.52 | $1,819.70 | $4,265.80 |
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 $588.84 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $588.84 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $239.88 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $891.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $177.83 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $117.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $831.76 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 5.9 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 $10,682MD $1,821
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.