How much rates vary
Facilitymedian $5,370 · 10th to 90th $871 to $11,749Professionalmedian $2,692 · 10th to 90th $1,479 to $3,981
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,548.82 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,818.38 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $4,265.80 Typical High $6,025.60 | Professional | 50 · Both sides | $2,238.72 | $4,265.80 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $446.68 Typical High $630.96 | Professional | 80 · Assistant surgeon | $239.88 | $446.68 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $398.11 Typical High $562.34 | Professional | AS · PA/NP assist | $208.93 | $398.11 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,168.69 | Facility | None | $741.31 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,570.40 | $3,890.45 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,398.83 | $2,691.53 |
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 $1,202.26 Median $2,398.83 Typical High $4,466.84 | Professional | None | $1,202.26 | $2,398.83 | $4,466.84 |
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 $776.25 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $776.25 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $309.03 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,174.90 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $234.42 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,698.24 | $1,698.24 |
Where Connecticut sits
The same service costs 7.8 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
$2,692
AK $6,761TX $871
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.