How much rates vary
Facilitymedian $4,266 · 10th to 90th $646 to $14,454Professionalmedian $2,188 · 10th to 90th $1,288 to $3,020
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 $1,348.96 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,348.96 | $2,041.74 | $2,041.74 |
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 $1,230.27 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,230.27 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $3,311.31 Typical High $4,570.88 | Professional | 50 · Both sides | $1,819.70 | $3,311.31 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,380.38 Typical High $1,905.46 | Professional | 62 · Two surgeons | $758.58 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $346.74 Typical High $478.63 | Professional | 80 · Assistant surgeon | $194.98 | $346.74 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $309.03 Typical High $426.58 | Professional | AS · PA/NP assist | $169.82 | $309.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,949.84 | $3,162.28 |
ConnectiCare Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,318.26 | $2,041.74 | $4,265.80 |
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 $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $676.08 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,023.29 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $134.90 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $954.99 | $1,445.44 | $1,445.44 |
Where Connecticut sits
The same service costs 4.8 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· 12th of 51
$2,188
AK $5,012TX $1,047
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.