How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,096 to $21,878Professionalmedian $1,380 · 10th to 90th $794 to $2,138
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | None | $870.96 | $1,258.93 | $1,258.93 |
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 $794.33 Median $1,548.82 Typical High $2,089.30 | Professional | None | $794.33 | $1,548.82 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $2,238.72 Typical High $3,090.30 | Professional | 50 · Both sides | $1,174.90 | $2,238.72 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $239.88 Typical High $331.13 | Professional | 80 · Assistant surgeon | $125.89 | $239.88 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $208.93 Typical High $288.40 | Professional | AS · PA/NP assist | $109.65 | $208.93 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,412.54 | $1,995.26 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,513.56 | Professional | None | $954.99 | $1,288.25 | $1,513.56 |
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 $676.08 Median $1,258.93 Typical High $2,290.87 | Professional | None | $676.08 | $1,258.93 | $2,290.87 |
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 $436.52 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $436.52 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $128.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $87.10 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $602.56 | $891.25 | $891.25 |
Where Connecticut sits
The same service costs 8.1 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· 17th of 51
$1,380
AK $3,548TX $437
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.