How much rates vary
Facilitymedian $4,169 · 10th to 90th $851 to $12,303Professionalmedian $2,512 · 10th to 90th $1,349 to $3,802
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,238.72 | $2,238.72 |
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 $1,412.54 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,691.53 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $3,981.07 Typical High $5,623.41 | Professional | 50 · Both sides | $2,041.74 | $3,981.07 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $426.58 Typical High $602.56 | Professional | 80 · Assistant surgeon | $218.78 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $371.54 Typical High $524.81 | Professional | AS · PA/NP assist | $190.55 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,467.37 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,905.46 | $2,187.76 | $3,630.78 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,995.26 | $2,344.23 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,122.02 | $2,137.96 | $4,168.69 |
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 $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $295.12 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,122.02 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $223.87 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 15.8 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· 11th of 51
$2,512
AK $6,310TX $398
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.