How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,000 to $14,125Professionalmedian $1,349 · 10th to 90th $794 to $2,089
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $891.25 | $1,445.44 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $12,302.69 Typical High $15,848.93 | Facility | None | $7,585.78 | $12,302.69 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,548.82 Typical High $1,949.84 | Professional | None | $812.83 | $1,548.82 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $2,344.23 Typical High $2,951.21 | Professional | 50 · Both sides | $1,202.26 | $2,344.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $977.24 Typical High $1,230.27 | Professional | 62 · Two surgeons | $501.19 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $245.47 Typical High $316.23 | Professional | 80 · Assistant surgeon | $128.82 | $245.47 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $218.78 Typical High $275.42 | Professional | AS · PA/NP assist | $112.20 | $218.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,570.88 Typical High $5,623.41 | Facility | None | $1,000.00 | $4,570.88 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,041.74 | Professional | None | $794.33 | $1,202.26 | $2,041.74 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $4,466.84 | Facility | None | $630.96 | $3,311.31 | $4,466.84 |
ConnectiCare Setting Professional Modifier None Typical Low $446.68 Median $812.83 Typical High $1,348.96 | Professional | None | $446.68 | $812.83 | $1,348.96 |
Health New England Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $812.83 Median $1,071.52 Typical High $2,884.03 | Professional | None | $812.83 | $1,071.52 | $2,884.03 |
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 $537.03 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $794.33 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $741.31 | $1,000.00 | $1,000.00 |
Where Connecticut sits
The same service costs 3.7 times more in Wisconsin 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
WI $9,756MT $2,637
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.