How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $22,909Professionalmedian $1,585 · 10th to 90th $912 to $2,455
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 $1,000.00 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,737.80 Typical High $2,398.83 | Professional | None | $933.25 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,630.27 Typical High $3,630.78 | Professional | 50 · Both sides | $1,380.38 | $2,630.27 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $281.84 Typical High $380.19 | Professional | 80 · Assistant surgeon | $144.54 | $281.84 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $245.47 Typical High $338.84 | Professional | AS · PA/NP assist | $128.82 | $245.47 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $13,803.84 Typical High $17,378.01 | Facility | None | $1,000.00 | $13,803.84 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,621.81 | $2,344.23 |
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 $1,096.48 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,479.11 | $1,737.80 |
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 $776.25 Median $1,445.44 Typical High $2,691.53 | Professional | None | $776.25 | $1,445.44 | $2,691.53 |
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 $501.19 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $501.19 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $199.53 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $758.58 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $151.36 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $100.00 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $707.95 | $1,023.29 | $1,023.29 |
Where Connecticut sits
The same service costs 8.5 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
$1,585
AK $4,074TX $479
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.