How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $14,125Professionalmedian $1,230 · 10th to 90th $759 to $1,905
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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,698.24 | Professional | None | $891.25 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,819.70 | Professional | None | $758.58 | $1,202.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $194.98 Typical High $288.40 | Professional | 80 · Assistant surgeon | $117.49 | $194.98 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $169.82 Typical High $251.19 | Professional | AS · PA/NP assist | $102.33 | $169.82 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $5,623.41 Typical High $6,918.31 | Facility | None | $549.54 | $5,623.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,995.26 | Professional | None | $933.25 | $1,230.27 | $1,995.26 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,258.93 | $1,412.54 |
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 $741.31 Median $1,047.13 Typical High $2,511.89 | Professional | None | $741.31 | $1,047.13 | $2,511.89 |
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 $446.68 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $446.68 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $177.83 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $660.69 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $131.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $89.13 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $616.60 | $977.24 | $977.24 |
Where Connecticut sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $1,932
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.