How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,445 · 10th to 90th $741 to $2,042
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 $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | None | $812.83 | $1,148.15 | $1,148.15 |
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 $724.44 Median $1,445.44 Typical High $1,905.46 | Professional | None | $724.44 | $1,445.44 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $891.25 Typical High $1,202.26 | Professional | 62 · Two surgeons | $457.09 | $891.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $229.09 Typical High $309.03 | Professional | 80 · Assistant surgeon | $117.49 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $102.33 | $199.53 | $269.15 |
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 $1,258.93 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,288.25 | $1,995.26 |
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 $977.24 Median $1,318.26 Typical High $1,380.38 | Professional | None | $977.24 | $1,318.26 | $1,380.38 |
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 $630.96 Median $1,202.26 Typical High $2,290.87 | Professional | None | $630.96 | $1,202.26 | $2,290.87 |
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 $407.38 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $407.38 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $602.56 | $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 $81.28 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $562.34 | $812.83 | $812.83 |
Where Connecticut sits
The same service costs 7.4 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
$1,445
AK $3,467TX $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.