How much rates vary
Facilitymedian $6,310 · 10th to 90th $871 to $21,878Professionalmedian $1,288 · 10th to 90th $708 to $1,905
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 $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | None | $794.33 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,348.96 Typical High $1,862.09 | Professional | None | $691.83 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,995.26 Typical High $2,818.38 | Professional | 50 · Both sides | $1,047.13 | $1,995.26 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $213.80 Typical High $295.12 | Professional | 80 · Assistant surgeon | $109.65 | $213.80 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $186.21 Typical High $263.03 | Professional | AS · PA/NP assist | $97.72 | $186.21 | $263.03 |
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 $1,202.26 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,479.11 | $1,819.70 |
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 $851.14 Median $1,148.15 Typical High $1,548.82 | Professional | None | $851.14 | $1,148.15 | $1,548.82 |
Health New England Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $602.56 Median $1,202.26 Typical High $2,089.30 | Professional | None | $602.56 | $1,202.26 | $2,089.30 |
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 $398.11 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $398.11 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $812.83 |
Where Connecticut sits
The same service costs 7.6 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
$1,349
AK $3,162TX $417
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.