How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,380 · 10th to 90th $776 to $2,042
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 $1,288.25 Typical High $1,288.25 | Professional | None | $870.96 | $1,288.25 | $1,288.25 |
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 $776.25 Median $1,479.11 Typical High $2,041.74 | Professional | None | $776.25 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $2,187.76 Typical High $3,090.30 | Professional | 50 · Both sides | $1,148.15 | $2,187.76 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $912.01 Typical High $1,288.25 | Professional | 62 · Two surgeons | $478.63 | $912.01 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $234.42 Typical High $323.59 | Professional | 80 · Assistant surgeon | $123.03 | $234.42 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $204.17 Typical High $288.40 | Professional | AS · PA/NP assist | $107.15 | $204.17 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $5,370.32 | Facility | None | $851.14 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,380.38 | $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 $933.25 Median $1,258.93 Typical High $1,479.11 | Professional | None | $933.25 | $1,258.93 | $1,479.11 |
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 $660.69 Median $1,230.27 Typical High $2,290.87 | Professional | None | $660.69 | $1,230.27 | $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 $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $173.78 | $257.04 | $257.04 |
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 $131.83 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $87.10 | $128.82 | $128.82 |
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 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· 15th of 51
$1,380
AK $3,467TX $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.