How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,000 to $21,878Professionalmedian $1,288 · 10th to 90th $724 to $1,995
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 $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | None | $812.83 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,380.38 Typical High $1,949.84 | Professional | None | $741.31 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $2,089.30 Typical High $2,884.03 | Professional | 50 · Both sides | $1,096.48 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $870.96 Typical High $1,230.27 | Professional | 62 · Two surgeons | $457.09 | $870.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $223.87 Typical High $309.03 | Professional | 80 · Assistant surgeon | $114.82 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $194.98 Typical High $269.15 | Professional | AS · PA/NP assist | $102.33 | $194.98 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,000.00 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,258.93 | $1,862.09 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,380.38 | Professional | None | $891.25 | $1,202.26 | $1,380.38 |
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 $616.60 Median $1,148.15 Typical High $2,137.96 | Professional | None | $616.60 | $1,148.15 | $2,137.96 |
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 $407.38 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $616.60 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $575.44 | $831.76 | $831.76 |
Where Connecticut sits
The same service costs 7.4 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· 15th of 51
$1,288
AK $3,311TX $447
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.