How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,023 · 10th to 90th $550 to $1,549
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 $630.96 Median $912.01 Typical High $912.01 | Professional | None | $630.96 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,479.11 | Professional | None | $562.34 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,584.89 Typical High $2,238.72 | Professional | 50 · Both sides | $812.83 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $660.69 Typical High $933.25 | Professional | 62 · Two surgeons | $346.74 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $87.10 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $75.86 | $147.91 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,479.11 | Professional | None | $831.76 | $954.99 | $1,479.11 |
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 $707.95 Median $891.25 Typical High $1,071.52 | Professional | None | $707.95 | $891.25 | $1,071.52 |
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 $489.78 Median $912.01 Typical High $1,659.59 | Professional | None | $489.78 | $912.01 | $1,659.59 |
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 $316.23 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $316.23 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $63.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $645.65 | $645.65 |
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· 14th of 51
$1,023
AK $2,570TX $331
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.