How much rates vary
Facilitymedian $6,166 · 10th to 90th $977 to $14,125Professionalmedian $1,549 · 10th to 90th $891 to $2,512
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,698.24 | $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 $851.14 Median $1,548.82 Typical High $2,089.30 | Professional | None | $851.14 | $1,548.82 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $954.99 Typical High $1,318.26 | Professional | 62 · Two surgeons | $537.03 | $954.99 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $239.88 Typical High $338.84 | Professional | 80 · Assistant surgeon | $138.04 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $120.23 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,511.38 Typical High $10,715.19 | Facility | None | $741.31 | $8,511.38 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,548.82 | $2,754.23 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,380.38 | $1,778.28 |
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 $1,412.54 Typical High $3,019.95 | Professional | None | $794.33 | $1,412.54 | $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 $575.44 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $575.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $229.09 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $870.96 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $114.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $812.83 | $1,202.26 | $1,202.26 |
Where Connecticut sits
The same service costs 4.4 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 $10,992HI $2,489
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.