How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,000 to $21,878Professionalmedian $1,549 · 10th to 90th $891 to $2,399
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 $977.24 Median $1,445.44 Typical High $1,445.44 | Professional | None | $977.24 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $17,378.01 Typical High $25,703.96 | Facility | None | $3,715.35 | $17,378.01 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,290.87 | Professional | None | $912.01 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $2,511.89 Typical High $3,467.37 | Professional | 50 · Both sides | $1,318.26 | $2,511.89 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $1,071.52 Typical High $1,445.44 | Professional | 62 · Two surgeons | $549.54 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $141.25 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $234.42 Typical High $323.59 | Professional | AS · PA/NP assist | $123.03 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,000.00 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,380.38 | $1,548.82 | $2,238.72 |
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 $1,071.52 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,412.54 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,570.40 | Professional | None | $758.58 | $1,412.54 | $2,570.40 |
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 $489.78 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $489.78 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $194.98 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $741.31 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $147.91 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $691.83 | $1,023.29 | $1,023.29 |
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· 20th of 51
$1,549
AK $3,981TX $501
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.