How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,047 to $15,136Professionalmedian $1,820 · 10th to 90th $1,000 to $2,630
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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,995.26 | $1,995.26 |
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 $977.24 Median $1,698.24 Typical High $2,570.40 | Professional | None | $977.24 | $1,698.24 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,511.89 Typical High $3,801.89 | Professional | 50 · Both sides | $1,479.11 | $2,511.89 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,047.13 Typical High $1,621.81 | Professional | 62 · Two surgeons | $616.60 | $1,047.13 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $269.15 Typical High $407.38 | Professional | 80 · Assistant surgeon | $158.49 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $234.42 Typical High $354.81 | Professional | AS · PA/NP assist | $138.04 | $234.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,456.54 Typical High $8,128.31 | Facility | None | $851.14 | $6,456.54 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,698.24 | $2,570.40 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,737.80 | $3,467.37 |
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 $575.44 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $575.44 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $229.09 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $851.14 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $173.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $794.33 | $1,380.38 | $1,380.38 |
Where Connecticut sits
The same service costs 5.1 times more in Wisconsin 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· 16th of 51
$1,995
WI $4,677TX $912
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.