How much rates vary
Facilitymedian $3,715 · 10th to 90th $851 to $8,128Professionalmedian $2,951 · 10th to 90th $1,660 to $4,467
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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $3,162.28 Typical High $4,168.69 | Professional | None | $1,621.81 | $3,162.28 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,995.26 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,023.29 | $1,995.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $501.19 Typical High $660.69 | Professional | 80 · Assistant surgeon | $257.04 | $501.19 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $446.68 Typical High $575.44 | Professional | AS · PA/NP assist | $229.09 | $446.68 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $2,691.53 | Facility | None | $851.14 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $4,168.69 | Professional | None | $2,818.38 | $3,630.78 | $4,168.69 |
ConnectiCare Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,754.23 | $3,801.89 |
Health New England Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | None | $15,135.61 | $15,135.61 | $15,135.61 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $4,786.30 | Professional | None | $1,380.38 | $2,754.23 | $4,786.30 |
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 $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $912.01 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $363.08 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,380.38 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $275.42 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $181.97 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,862.09 | $1,862.09 |
Where Connecticut sits
The same service costs 21.4 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· 12th of 51
$3,020
AK $7,244TX $339
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.