How much rates vary
Facilitymedian $6,310 · 10th to 90th $977 to $14,125Professionalmedian $1,259 · 10th to 90th $794 to $1,905
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 $870.96 Median $1,412.54 Typical High $1,412.54 | Professional | None | $870.96 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,230.27 Typical High $1,778.28 | Professional | None | $741.31 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,778.28 Typical High $2,630.27 | Professional | 50 · Both sides | $1,122.02 | $1,778.28 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $741.31 Typical High $1,122.02 | Professional | 62 · Two surgeons | $467.74 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $117.49 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $165.96 Typical High $245.47 | Professional | AS · PA/NP assist | $102.33 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,258.93 | $1,949.84 |
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 $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
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 $741.31 Median $1,096.48 Typical High $2,187.76 | Professional | None | $741.31 | $1,096.48 | $2,187.76 |
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 $426.58 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $426.58 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $173.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $645.65 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $128.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $87.10 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $602.56 | $977.24 | $977.24 |
Where Connecticut sits
The same service costs 7.4 times more in Oklahoma 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· 19th of 51
$1,380
OK $3,890TX $525
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.