How much rates vary
Facilitymedian $3,548 · 10th to 90th $851 to $8,913Professionalmedian $2,344 · 10th to 90th $1,259 to $3,467
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 $1,380.38 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,949.84 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,318.26 | $2,344.23 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $371.54 Typical High $512.86 | Professional | 80 · Assistant surgeon | $204.17 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $323.59 Typical High $446.68 | Professional | AS · PA/NP assist | $177.83 | $323.59 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $3,311.31 | Facility | None | $1,000.00 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,311.31 | Professional | None | $1,905.46 | $2,187.76 | $3,311.31 |
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 $1,584.89 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,584.89 | $2,041.74 | $2,187.76 |
Health New England Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Professional | None | $12,022.64 | $12,022.64 | $12,022.64 |
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 $1,023.29 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,023.29 | $2,041.74 | $3,801.89 |
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 $691.83 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $691.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $275.42 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,047.13 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $138.04 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $977.24 | $1,380.38 | $1,380.38 |
Where Connecticut sits
The same service costs 17.0 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
$2,344
AK $5,888TX $347
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.