How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,047 to $12,303Professionalmedian $5,888 · 10th to 90th $3,388 to $8,913
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 $3,630.78 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,630.78 | $4,897.79 | $4,897.79 |
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 $3,467.37 Median $6,025.60 Typical High $7,943.28 | Professional | None | $3,467.37 | $6,025.60 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $5,248.07 Median $8,912.51 Typical High $12,022.64 | Professional | 50 · Both sides | $5,248.07 | $8,912.51 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $3,715.35 Typical High $5,011.87 | Professional | 62 · Two surgeons | $2,187.76 | $3,715.35 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $954.99 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $549.54 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $831.76 Typical High $1,122.02 | Professional | AS · PA/NP assist | $489.78 | $831.76 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,549.93 Typical High $12,022.64 | Facility | None | $851.14 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $8,709.64 | Professional | None | $5,011.87 | $5,623.41 | $8,709.64 |
ConnectiCare Setting Professional Modifier None Typical Low $4,073.80 Median $5,495.41 Typical High $5,888.44 | Professional | None | $4,073.80 | $5,495.41 | $5,888.44 |
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 $2,951.21 Median $5,495.41 Typical High $10,232.93 | Professional | None | $2,951.21 | $5,495.41 | $10,232.93 |
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 $1,862.09 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,862.09 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $741.31 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,754.23 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $549.54 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $371.54 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,570.40 | $3,388.44 | $3,388.44 |
Where Connecticut sits
The same service costs 20.4 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· 11th of 51
$5,888
AK $15,488TX $759
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.