How much rates vary
Facilitymedian $5,495 · 10th to 90th $871 to $12,303Professionalmedian $1,175 · 10th to 90th $646 to $1,738
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 $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | None | $724.44 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,748.98 Typical High $13,803.84 | Facility | None | $2,754.23 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,698.24 | Professional | None | $645.65 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $758.58 Typical High $1,071.52 | Professional | 62 · Two surgeons | $407.38 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $194.98 Typical High $275.42 | Professional | 80 · Assistant surgeon | $102.33 | $194.98 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $169.82 Typical High $239.88 | Professional | AS · PA/NP assist | $89.13 | $169.82 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,122.02 | $1,698.24 |
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 $794.33 Median $1,071.52 Typical High $1,230.27 | Professional | None | $794.33 | $1,071.52 | $1,230.27 |
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 $562.34 Median $1,023.29 Typical High $1,905.46 | Professional | None | $562.34 | $1,023.29 | $1,905.46 |
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 $363.08 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $741.31 | $741.31 |
Where Connecticut sits
The same service costs 8.5 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· 14th of 51
$1,175
AK $2,951TX $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.