How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,349 to $72,444Professionalmedian $501 · 10th to 90th $282 to $776
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 $346.74 Median $501.19 Typical High $501.19 | Professional | None | $346.74 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $61,659.50 Typical High $91,201.08 | Facility | None | $8,128.31 | $61,659.50 | $91,201.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $691.83 | Professional | None | $288.40 | $524.81 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $83.18 Typical High $109.65 | Professional | 80 · Assistant surgeon | $45.71 | $83.18 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $72.44 Typical High $97.72 | Professional | AS · PA/NP assist | $39.81 | $72.44 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $28,183.83 Typical High $34,673.69 | Facility | None | $549.54 | $28,183.83 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $851.14 | Professional | None | $467.74 | $478.63 | $851.14 |
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 $380.19 Median $416.87 Typical High $524.81 | Professional | None | $380.19 | $416.87 | $524.81 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $19,498.45 | Facility | None | $1,348.96 | $9,549.93 | $19,498.45 |
United Setting Professional Modifier None Typical Low $239.88 Median $436.52 Typical High $933.25 | Professional | None | $239.88 | $436.52 | $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 $173.78 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $257.04 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $51.29 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $34.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $239.88 | $346.74 | $346.74 |
Where Connecticut sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.