How much rates vary
Facilitymedian $6,166 · 10th to 90th $871 to $15,849Professionalmedian $1,000 · 10th to 90th $617 to $1,585
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 $660.69 Median $1,148.15 Typical High $1,148.15 | Professional | None | $660.69 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $15,848.93 Typical High $18,620.87 | Facility | None | $1,122.02 | $15,848.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,479.11 | Professional | None | $616.60 | $1,000.00 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $616.60 Typical High $933.25 | Professional | 62 · Two surgeons | $380.19 | $616.60 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $158.49 Typical High $234.42 | Professional | 80 · Assistant surgeon | $97.72 | $158.49 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $138.04 Typical High $208.93 | Professional | AS · PA/NP assist | $85.11 | $138.04 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,621.81 | Professional | None | $851.14 | $1,000.00 | $1,621.81 |
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 $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,047.13 | $1,148.15 |
Health New England Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $616.60 Median $851.14 Typical High $2,041.74 | Professional | None | $616.60 | $851.14 | $2,041.74 |
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 $363.08 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $363.08 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $144.54 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $537.03 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $107.15 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $501.19 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 5.1 times more in Wisconsin 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
WI $10,170MT $2,000
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.