How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,122 to $21,878Professionalmedian $1,514 · 10th to 90th $871 to $2,344
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 $977.24 Median $1,412.54 Typical High $1,412.54 | Professional | None | $977.24 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $16,595.87 Typical High $25,703.96 | Facility | None | $3,715.35 | $16,595.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,238.72 | Professional | None | $891.25 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,454.71 Typical High $3,388.44 | Professional | 50 · Both sides | $1,288.25 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $1,047.13 Typical High $1,412.54 | Professional | 62 · Two surgeons | $549.54 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $263.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $141.25 | $263.03 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $229.09 Typical High $316.23 | Professional | AS · PA/NP assist | $120.23 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $9,549.93 Typical High $12,022.64 | Facility | None | $1,000.00 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,513.56 | $2,187.76 |
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 $1,047.13 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,380.38 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,380.38 Typical High $2,570.40 | Professional | None | $741.31 | $1,380.38 | $2,570.40 |
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 $489.78 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $489.78 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $724.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $144.54 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $97.72 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $676.08 | $1,000.00 | $1,000.00 |
Where Connecticut sits
The same service costs 7.9 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· 16th of 51
$1,514
AK $3,890TX $490
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.