How much rates vary
Facilitymedian $5,495 · 10th to 90th $871 to $9,333Professionalmedian $1,148 · 10th to 90th $631 to $1,698
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 $1,380.38 Median $2,818.38 Typical High $10,232.93 | Facility | None | $1,380.38 | $2,818.38 | $10,232.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $1,621.81 | Professional | None | $660.69 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,737.80 Typical High $2,398.83 | Professional | 50 · Both sides | $954.99 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $398.11 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $102.33 | $186.21 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $162.18 Typical High $223.87 | Professional | AS · PA/NP assist | $89.13 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,659.59 | Professional | None | $954.99 | $1,096.48 | $1,659.59 |
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 $1,000.00 Typical High $1,174.90 | Professional | None | $794.33 | $1,000.00 | $1,174.90 |
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 $537.03 Median $1,023.29 Typical High $1,862.09 | Professional | None | $537.03 | $1,023.29 | $1,862.09 |
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 $354.81 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $354.81 | $512.86 | $512.86 |
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 $537.03 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $154.88 | $154.88 |
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 $501.19 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $501.19 | $724.44 | $724.44 |
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
$1,148
AK $2,884TX $363
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.