How much rates vary
Facilitymedian $5,623 · 10th to 90th $933 to $12,303Professionalmedian $2,188 · 10th to 90th $1,230 to $3,162
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 $1,584.89 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,584.89 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,318.26 | $2,344.23 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,388.44 Typical High $4,265.80 | Professional | 50 · Both sides | $1,995.26 | $3,388.44 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,445.44 Typical High $1,778.28 | Professional | 62 · Two surgeons | $831.76 | $1,445.44 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $363.08 Typical High $457.09 | Professional | 80 · Assistant surgeon | $208.93 | $363.08 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $316.23 Typical High $398.11 | Professional | AS · PA/NP assist | $186.21 | $316.23 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $4,466.84 | Facility | None | $851.14 | $3,630.78 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $3,548.13 | Professional | None | $1,148.15 | $1,737.80 | $3,548.13 |
ConnectiCare Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,187.76 | Professional | None | $912.01 | $1,513.56 | $2,187.76 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $4,570.88 | Professional | None | $1,148.15 | $1,698.24 | $4,570.88 |
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 $794.33 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $794.33 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $316.23 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,174.90 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $234.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,479.11 | $1,479.11 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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 $10,675KY $2,688
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.