How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,148 to $15,849Professionalmedian $1,413 · 10th to 90th $871 to $2,089
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $1,659.59 | Professional | None | $912.01 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $15,135.61 Typical High $17,782.79 | Facility | None | $3,235.94 | $15,135.61 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,380.38 Typical High $2,041.74 | Professional | None | $851.14 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $2,089.30 Typical High $3,090.30 | Professional | 50 · Both sides | $1,230.27 | $2,089.30 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $870.96 Typical High $1,288.25 | Professional | 62 · Two surgeons | $512.86 | $870.96 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $218.78 Typical High $331.13 | Professional | 80 · Assistant surgeon | $131.83 | $218.78 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $194.98 Typical High $288.40 | Professional | AS · PA/NP assist | $114.82 | $194.98 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $10,471.29 Typical High $13,182.57 | Facility | None | $1,000.00 | $10,471.29 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,445.44 | $2,290.87 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,951.21 | Professional | None | $870.96 | $1,202.26 | $2,951.21 |
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 $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $776.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $724.44 | $1,148.15 | $1,148.15 |
Where Connecticut sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.