How much rates vary
Facilitymedian $6,166 · 10th to 90th $912 to $12,303Professionalmedian $1,622 · 10th to 90th $933 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 $4,365.16 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 $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,513.56 | $1,513.56 |
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 $933.25 Median $1,698.24 Typical High $2,290.87 | Professional | None | $933.25 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,511.89 Typical High $3,467.37 | Professional | 50 · Both sides | $1,412.54 | $2,511.89 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $151.36 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $234.42 Typical High $323.59 | Professional | AS · PA/NP assist | $131.83 | $234.42 | $323.59 |
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 $1,513.56 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,778.28 | $2,398.83 |
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 $1,122.02 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,513.56 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,584.89 Typical High $2,691.53 | Professional | None | $794.33 | $1,584.89 | $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 $512.86 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $208.93 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $776.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $154.88 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $724.44 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 8.9 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· 12th of 51
$1,738
AK $4,169TX $468
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.