How much rates vary
Facilitymedian $6,166 · 10th to 90th $912 to $14,125Professionalmedian $1,660 · 10th to 90th $891 to $2,630
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $2,187.76 | Professional | None | $870.96 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,398.83 Typical High $3,235.94 | Professional | 50 · Both sides | $1,288.25 | $2,398.83 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $257.04 Typical High $346.74 | Professional | 80 · Assistant surgeon | $138.04 | $257.04 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $223.87 Typical High $302.00 | Professional | AS · PA/NP assist | $120.23 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $5,495.41 | Facility | None | $851.14 | $4,466.84 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,737.80 | $2,754.23 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,479.11 | $1,862.09 |
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 $794.33 Median $1,445.44 Typical High $3,019.95 | Professional | None | $794.33 | $1,445.44 | $3,019.95 |
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 $562.34 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $223.87 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $851.14 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $794.33 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska 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
AK $10,681HI $2,676
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.