How much rates vary
Facilitymedian $4,169 · 10th to 90th $871 to $9,550Professionalmedian $457 · 10th to 90th $288 to $692
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 $302.00 Median $524.81 Typical High $575.44 | Professional | None | $302.00 | $524.81 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $3,715.35 Typical High $10,964.78 | Facility | None | $2,754.23 | $3,715.35 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $691.83 | Professional | None | $281.84 | $457.09 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $288.40 Typical High $436.52 | Professional | 62 · Two surgeons | $173.78 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $74.13 Typical High $109.65 | Professional | 80 · Assistant surgeon | $44.67 | $74.13 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $64.57 Typical High $95.50 | Professional | AS · PA/NP assist | $38.90 | $64.57 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,000.00 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $741.31 | Professional | None | $398.11 | $457.09 | $741.31 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | None | $478.63 | $478.63 | $537.03 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $933.25 | Professional | None | $288.40 | $389.05 | $933.25 |
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 $162.18 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $162.18 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $66.07 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $363.08 | $363.08 |
Where Connecticut sits
The same service costs 6.6 times more in Oklahoma 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
OK $6,126MT $925
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.