How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,413 · 10th to 90th $813 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 $4,365.16 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 $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,479.11 | $1,479.11 |
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 $831.76 Median $1,584.89 Typical High $1,995.26 | Professional | None | $831.76 | $1,584.89 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $2,344.23 Typical High $3,019.95 | Professional | 50 · Both sides | $1,230.27 | $2,344.23 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $1,000.00 Typical High $1,258.93 | Professional | 62 · Two surgeons | $512.86 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $251.19 Typical High $323.59 | Professional | 80 · Assistant surgeon | $131.83 | $251.19 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $218.78 Typical High $281.84 | Professional | AS · PA/NP assist | $114.82 | $218.78 | $281.84 |
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 $812.83 Median $1,258.93 Typical High $2,238.72 | Professional | None | $812.83 | $1,258.93 | $2,238.72 |
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 $562.34 Median $954.99 Typical High $1,621.81 | Professional | None | $562.34 | $954.99 | $1,621.81 |
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 $831.76 Median $1,122.02 Typical High $3,090.30 | Professional | None | $831.76 | $1,122.02 | $3,090.30 |
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 $549.54 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $549.54 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $218.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $831.76 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $776.25 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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 $8,254FL $2,626
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.