How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,000 to $14,454Professionalmedian $1,047 · 10th to 90th $692 to $1,660
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 $691.83 Median $1,023.29 Typical High $1,258.93 | Professional | None | $691.83 | $1,023.29 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $12,302.69 Typical High $16,595.87 | Facility | None | $5,495.41 | $12,302.69 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $1,584.89 | Professional | None | $707.95 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $676.08 Typical High $1,000.00 | Professional | 62 · Two surgeons | $436.52 | $676.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $173.78 Typical High $251.19 | Professional | 80 · Assistant surgeon | $112.20 | $173.78 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $151.36 Typical High $223.87 | Professional | AS · PA/NP assist | $97.72 | $151.36 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,025.60 Typical High $7,585.78 | Facility | None | $1,000.00 | $6,025.60 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,659.59 | Professional | None | $977.24 | $1,174.90 | $1,659.59 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $4,168.69 | Facility | None | $724.44 | $1,174.90 | $4,168.69 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,288.25 | $1,318.26 |
Health New England Setting Facility Modifier None Typical Low $1,318.26 Median $5,754.40 Typical High $6,606.93 | Facility | None | $1,318.26 | $5,754.40 | $6,606.93 |
Health New England Setting Professional Modifier None Typical Low $331.13 Median $812.83 Typical High $1,348.96 | Professional | None | $331.13 | $812.83 | $1,348.96 |
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 $758.58 Median $1,071.52 Typical High $2,187.76 | Professional | None | $758.58 | $1,071.52 | $2,187.76 |
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 $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $363.08 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $549.54 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $109.65 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $72.44 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $512.86 | $724.44 | $724.44 |
Where Connecticut sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.