How much rates vary
Facilitymedian $6,310 · 10th to 90th $851 to $11,749Professionalmedian $1,622 · 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 $4,365.16 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 $977.24 Median $1,513.56 Typical High $1,513.56 | Professional | None | $977.24 | $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 $912.01 Median $1,778.28 Typical High $2,398.83 | Professional | None | $912.01 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,630.27 Typical High $3,467.37 | Professional | 50 · Both sides | $1,380.38 | $2,630.27 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $281.84 Typical High $371.54 | Professional | 80 · Assistant surgeon | $144.54 | $281.84 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $245.47 Typical High $323.59 | Professional | AS · PA/NP assist | $128.82 | $245.47 | $323.59 |
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 $1,513.56 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 $1,905.46 | Professional | None | $1,122.02 | $1,513.56 | $1,905.46 |
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 $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 $489.78 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $489.78 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $194.98 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $741.31 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $147.91 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $97.72 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $691.83 | $1,071.52 | $1,071.52 |
Where Connecticut sits
The same service costs 8.3 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· 13th of 51
$1,738
AK $4,169TX $501
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.