How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $12,303Professionalmedian $1,778 · 10th to 90th $1,023 to $2,630
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 $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,584.89 | $1,584.89 |
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 $1,023.29 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,691.53 Typical High $3,715.35 | Professional | 50 · Both sides | $1,513.56 | $2,691.53 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,122.02 Typical High $1,584.89 | Professional | 62 · Two surgeons | $645.65 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $288.40 Typical High $398.11 | Professional | 80 · Assistant surgeon | $162.18 | $288.40 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $251.19 Typical High $346.74 | Professional | AS · PA/NP assist | $141.25 | $251.19 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,388.44 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,621.81 | $1,862.09 | $2,570.40 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,698.24 | $1,995.26 |
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 $891.25 Median $1,659.59 Typical High $3,019.95 | Professional | None | $891.25 | $1,659.59 | $3,019.95 |
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 $588.84 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $234.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $117.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 7.9 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· 15th of 51
$1,778
AK $4,571TX $575
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.