How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,000 to $16,596Professionalmedian $2,692 · 10th to 90th $302 to $7,586
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 $3,890.45 Median $6,760.83 Typical High $10,232.93 | Facility | None | $3,890.45 | $6,760.83 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $3,235.94 Typical High $7,079.46 | Professional | None | $288.40 | $3,235.94 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $16,218.10 Typical High $19,952.62 | Facility | None | $1,000.00 | $16,218.10 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $2,691.53 Typical High $7,079.46 | Professional | None | $338.84 | $2,691.53 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $4,073.80 Typical High $10,715.19 | Professional | 50 · Both sides | $501.19 | $4,073.80 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $426.58 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $53.70 | $426.58 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $380.19 Typical High $1,000.00 | Professional | AS · PA/NP assist | $46.77 | $380.19 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,128.61 Typical High $6,760.83 | Facility | None | $851.14 | $5,128.61 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $4,466.84 Typical High $7,585.78 | Professional | None | $398.11 | $4,466.84 | $7,585.78 |
ConnectiCare Setting Facility Modifier None Typical Low $2,884.03 Median $6,918.31 Typical High $7,762.47 | Facility | None | $2,884.03 | $6,918.31 | $7,762.47 |
ConnectiCare Setting Professional Modifier None Typical Low $6,025.60 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,025.60 | $6,309.57 | $6,309.57 |
Health New England Setting Professional Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $21,877.62 | Professional | None | $21,877.62 | $21,877.62 | $21,877.62 |
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 $281.84 Median $1,258.93 Typical High $9,772.37 | Professional | None | $281.84 | $1,258.93 | $9,772.37 |
5 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 $151.36 Median $229.09 Typical High $3,548.13 | Professional | 52 · Reduced service | $151.36 | $229.09 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $91.20 Typical High $1,412.54 | Professional | 53 · Discontinued | $60.26 | $91.20 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $346.74 Typical High $5,370.32 | Professional | 54 · Surgery only | $229.09 | $346.74 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $69.18 Typical High $1,071.52 | Professional | 55 · Aftercare only | $45.71 | $69.18 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $45.71 Typical High $707.95 | Professional | 56 · Pre-op care only | $30.20 | $45.71 | $707.95 |
Where Connecticut sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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· 14th of 51
$3,311
AK $5,012NE $490
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.