How much rates vary
Facilitymedian $5,495 · 10th to 90th $871 to $11,749Professionalmedian $1,950 · 10th to 90th $1,413 to $3,020
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 $1,412.54 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,995.26 | $1,995.26 |
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 $1,819.70 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,819.70 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,122.02 Typical High $1,445.44 | Professional | 62 · Two surgeons | $831.76 | $1,122.02 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $281.84 Typical High $371.54 | Professional | 80 · Assistant surgeon | $208.93 | $281.84 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $245.47 Typical High $323.59 | Professional | AS · PA/NP assist | $181.97 | $245.47 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,981.07 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,981.07 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,041.74 | $3,388.44 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,089.30 | $2,137.96 | $2,137.96 |
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 $1,412.54 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,187.76 | $3,548.13 |
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 $707.95 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $707.95 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $281.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,047.13 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $213.80 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $977.24 | $1,412.54 | $1,412.54 |
Where Connecticut sits
The same service costs 8.7 times more in Alaska than in Texas. 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.
Connecticut· 28th of 51
$1,995
AK $7,244TX $832
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.