How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,000 to $21,878Professionalmedian $1,122 · 10th to 90th $631 to $1,698
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 $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $691.83 | $1,000.00 | $1,000.00 |
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 $630.96 Median $1,202.26 Typical High $1,659.59 | Professional | None | $630.96 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,778.28 Typical High $2,511.89 | Professional | 50 · Both sides | $933.25 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $177.83 Typical High $263.03 | Professional | 80 · Assistant surgeon | $95.50 | $177.83 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $165.96 Typical High $234.42 | Professional | AS · PA/NP assist | $87.10 | $165.96 | $234.42 |
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 $977.24 Median $1,096.48 Typical High $1,584.89 | Professional | None | $977.24 | $1,096.48 | $1,584.89 |
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 $758.58 Median $1,023.29 Typical High $1,174.90 | Professional | None | $758.58 | $1,023.29 | $1,174.90 |
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 $524.81 Median $977.24 Typical High $1,819.70 | Professional | None | $524.81 | $977.24 | $1,819.70 |
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 $346.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $524.81 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $489.78 | $707.95 | $707.95 |
Where Connecticut sits
The same service costs 7.8 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· 15th of 51
$1,122
AK $2,818TX $363
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.