How much rates vary
Facilitymedian $6,166 · 10th to 90th $977 to $12,303Professionalmedian $1,514 · 10th to 90th $891 to $2,291
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $1,445.44 | Professional | None | $977.24 | $1,445.44 | $1,445.44 |
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 $891.25 Median $1,513.56 Typical High $2,041.74 | Professional | None | $891.25 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $2,290.87 Typical High $3,090.30 | Professional | 50 · Both sides | $1,318.26 | $2,290.87 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $562.34 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $141.25 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $123.03 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,388.44 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,778.28 | $2,290.87 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,412.54 | $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 $741.31 Median $1,479.11 Typical High $2,570.40 | Professional | None | $741.31 | $1,479.11 | $2,570.40 |
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 $489.78 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $489.78 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $741.31 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $691.83 | $1,000.00 | $1,000.00 |
Where Connecticut sits
The same service costs 16.2 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· 18th of 51
$1,549
AK $3,890TX $240
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.