How much rates vary
Facilitymedian $6,457 · 10th to 90th $871 to $21,878Professionalmedian $1,445 · 10th to 90th $741 to $2,089
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 $831.76 Median $1,230.27 Typical High $1,230.27 | Professional | None | $831.76 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,445.44 Typical High $1,995.26 | Professional | None | $741.31 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $912.01 Typical High $1,258.93 | Professional | 62 · Two surgeons | $467.74 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $234.42 Typical High $316.23 | Professional | 80 · Assistant surgeon | $120.23 | $234.42 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $204.17 Typical High $275.42 | Professional | AS · PA/NP assist | $104.71 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,471.29 Typical High $12,882.50 | Facility | None | $851.14 | $10,471.29 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,318.26 | $2,041.74 |
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 $1,000.00 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,348.96 | $1,412.54 |
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 $645.65 Median $1,230.27 Typical High $2,344.23 | Professional | None | $645.65 | $1,230.27 | $2,344.23 |
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 $416.87 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $416.87 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $165.96 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $616.60 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $125.89 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $83.18 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $588.84 | $851.14 | $851.14 |
Where Connecticut sits
The same service costs 7.6 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· 13th of 51
$1,445
AK $3,548TX $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.