How much rates vary
Facilitymedian $6,761 · 10th to 90th $933 to $16,596Professionalmedian $871 · 10th to 90th $490 to $1,318
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 $537.03 Median $776.25 Typical High $776.25 | Professional | None | $537.03 | $776.25 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $12,882.50 Typical High $19,498.45 | Facility | None | $6,456.54 | $12,882.50 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $977.24 Typical High $1,318.26 | Professional | None | $489.78 | $977.24 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,412.54 Typical High $1,949.84 | Professional | 50 · Both sides | $724.44 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $588.84 Typical High $831.76 | Professional | 62 · Two surgeons | $309.03 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $147.91 Typical High $208.93 | Professional | 80 · Assistant surgeon | $77.62 | $147.91 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $131.83 Typical High $181.97 | Professional | AS · PA/NP assist | $67.61 | $131.83 | $181.97 |
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 $794.33 Median $851.14 Typical High $1,230.27 | Professional | None | $794.33 | $851.14 | $1,230.27 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $3,715.35 | Facility | None | $512.86 | $707.95 | $3,715.35 |
ConnectiCare Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $933.25 | Professional | None | $602.56 | $812.83 | $933.25 |
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 $407.38 Median $776.25 Typical High $1,412.54 | Professional | None | $407.38 | $776.25 | $1,412.54 |
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 $269.15 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $269.15 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $107.15 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $398.11 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $53.70 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $371.54 | $549.54 | $549.54 |
Where Connecticut sits
The same service costs 4.5 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 $7,632MT $1,703
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.