How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,000 to $15,136Professionalmedian $1,549 · 10th to 90th $912 to $2,455
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 $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,513.56 | $1,513.56 |
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 $912.01 Median $1,737.80 Typical High $2,290.87 | Professional | None | $912.01 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,570.40 Typical High $3,467.37 | Professional | 50 · Both sides | $1,380.38 | $2,570.40 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $1,071.52 Typical High $1,445.44 | Professional | 62 · Two surgeons | $575.44 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $147.91 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $128.82 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,165.95 Typical High $7,762.47 | Facility | None | $851.14 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,479.11 | $2,344.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,348.96 | $1,698.24 |
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 $776.25 Median $1,445.44 Typical High $2,691.53 | Professional | None | $776.25 | $1,445.44 | $2,691.53 |
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 $512.86 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $204.17 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $776.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $154.88 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $724.44 | $1,071.52 | $1,071.52 |
Where Connecticut sits
The same service costs 18.2 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
$1,549
AK $4,074TX $224
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.