How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $14,454Professionalmedian $2,188 · 10th to 90th $1,288 to $3,388
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 $1,479.11 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,479.11 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $12,589.25 Typical High $16,218.10 | Facility | None | $3,630.78 | $12,589.25 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,288.25 | $2,187.76 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $3,311.31 Typical High $4,786.30 | Professional | 50 · Both sides | $1,819.70 | $3,311.31 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,380.38 Typical High $1,995.26 | Professional | 62 · Two surgeons | $758.58 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $346.74 Typical High $512.86 | Professional | 80 · Assistant surgeon | $194.98 | $346.74 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $309.03 Typical High $446.68 | Professional | AS · PA/NP assist | $169.82 | $309.03 | $446.68 |
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 $1,548.82 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,137.96 | $3,311.31 |
ConnectiCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $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 $1,380.38 Median $2,137.96 Typical High $4,466.84 | Professional | None | $1,380.38 | $2,137.96 | $4,466.84 |
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 $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $741.31 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,096.48 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $147.91 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 5.5 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 $5,248TX $955
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.