How much rates vary
Facilitymedian $4,266 · 10th to 90th $646 to $14,454Professionalmedian $2,754 · 10th to 90th $1,585 to $4,266
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 $1,819.70 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,819.70 | $3,162.28 | $3,162.28 |
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 $1,584.89 Median $2,691.53 Typical High $4,073.80 | Professional | None | $1,584.89 | $2,691.53 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,981.07 Typical High $6,025.60 | Professional | 50 · Both sides | $2,344.23 | $3,981.07 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,698.24 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,000.00 | $1,698.24 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $426.58 Typical High $645.65 | Professional | 80 · Assistant surgeon | $251.19 | $426.58 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $371.54 Typical High $562.34 | Professional | AS · PA/NP assist | $218.78 | $371.54 | $562.34 |
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 $2,041.74 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,041.74 | $2,691.53 | $4,073.80 |
ConnectiCare Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
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 $1,698.24 Median $2,691.53 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,691.53 | $5,495.41 |
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 $912.01 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $912.01 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $363.08 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,380.38 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $275.42 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $181.97 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,187.76 | $2,187.76 |
Where Connecticut sits
The same service costs 5.8 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· 11th of 51
$2,884
AK $6,457TX $1,122
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.