How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,072 to $16,982Professionalmedian $891 · 10th to 90th $525 to $1,445
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 $6,760.83 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,760.83 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,023.29 | Professional | None | $575.44 | $851.14 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $14,454.40 Typical High $19,498.45 | Facility | None | $8,317.64 | $14,454.40 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $1,023.29 Typical High $1,380.38 | Professional | None | $524.81 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,513.56 Typical High $2,041.74 | Professional | 50 · Both sides | $776.25 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $158.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $83.18 | $158.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $72.44 | $141.25 | $190.55 |
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 $812.83 Median $933.25 Typical High $1,288.25 | Professional | None | $812.83 | $933.25 | $1,288.25 |
ConnectiCare Setting Facility Modifier None Typical Low $707.95 Median $7,244.36 Typical High $7,413.10 | Facility | None | $707.95 | $7,244.36 | $7,413.10 |
ConnectiCare Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,000.00 | Professional | None | $616.60 | $831.76 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $63.10 Median $125.89 Typical High $1,318.26 | Professional | None | $63.10 | $125.89 | $1,318.26 |
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 $446.68 Median $831.76 Typical High $1,621.81 | Professional | None | $446.68 | $831.76 | $1,621.81 |
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 $288.40 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $288.40 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $114.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $436.52 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $57.54 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $407.38 | $588.84 | $588.84 |
Where Connecticut sits
The same service costs 4.7 times more in Connecticut than in Montana. 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.
Physician feeFacility fee
CT $8,304MT $1,762
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.