How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,000 to $14,454Professionalmedian $1,950 · 10th to 90th $1,148 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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,174.90 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $3,235.94 Typical High $4,365.16 | Professional | 50 · Both sides | $1,737.80 | $3,235.94 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,348.96 Typical High $1,862.09 | Professional | 62 · Two surgeons | $724.44 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $338.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $186.21 | $338.84 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $302.00 Typical High $407.38 | Professional | AS · PA/NP assist | $162.18 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,762.47 Typical High $9,772.37 | Facility | None | $851.14 | $7,762.47 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,737.80 | $1,995.26 | $2,951.21 |
ConnectiCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,819.70 | $2,238.72 |
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 $1,000.00 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,000.00 | $1,862.09 | $3,388.44 |
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 $616.60 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $616.60 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $245.47 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $123.03 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $1,174.90 | $1,174.90 |
Where Connecticut sits
The same service costs 17.8 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· 19th of 51
$1,950
AK $5,129TX $288
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.