How much rates vary
Facilitymedian $4,266 · 10th to 90th $646 to $14,454Professionalmedian $2,455 · 10th to 90th $1,445 to $3,467
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 $1,548.82 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,548.82 | $2,344.23 | $2,344.23 |
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 $1,380.38 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,380.38 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $3,715.35 Typical High $5,128.61 | Professional | 50 · Both sides | $2,041.74 | $3,715.35 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,548.82 Typical High $2,187.76 | Professional | 62 · Two surgeons | $851.14 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $398.11 Typical High $549.54 | Professional | 80 · Assistant surgeon | $218.78 | $398.11 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $346.74 Typical High $478.63 | Professional | AS · PA/NP assist | $190.55 | $346.74 | $478.63 |
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 $1,698.24 Median $2,187.76 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,187.76 | $3,630.78 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
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 $1,513.56 Median $2,290.87 Typical High $4,897.79 | Professional | None | $1,513.56 | $2,290.87 | $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 $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $309.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,174.90 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,659.59 | $1,659.59 |
Where Connecticut sits
The same service costs 5.6 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
$2,455
AK $5,754TX $1,023
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.