How much rates vary
Facilitymedian $6,166 · 10th to 90th $977 to $14,125Professionalmedian $2,754 · 10th to 90th $1,698 to $4,169
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $3,235.94 | Professional | None | $1,905.46 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,659.59 | $2,630.27 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,621.81 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,047.13 | $1,621.81 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $407.38 Typical High $616.60 | Professional | 80 · Assistant surgeon | $263.03 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $354.81 Typical High $537.03 | Professional | AS · PA/NP assist | $234.42 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,165.95 Typical High $7,762.47 | Facility | None | $741.31 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $4,073.80 | Professional | None | $2,290.87 | $2,754.23 | $4,073.80 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,162.28 | Professional | None | $2,818.38 | $2,818.38 | $3,162.28 |
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 $1,584.89 Median $2,344.23 Typical High $4,897.79 | Professional | None | $1,584.89 | $2,344.23 | $4,897.79 |
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 $954.99 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $954.99 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $380.19 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,412.54 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $288.40 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $190.55 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,318.26 | $2,290.87 | $2,290.87 |
Where Connecticut sits
The same service costs 7.1 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· 13th of 51
$2,951
AK $7,079TX $1,000
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.