How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $14,454Professionalmedian $2,042 · 10th to 90th $1,202 to $3,090
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 $1,380.38 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,380.38 | $2,041.74 | $2,041.74 |
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 $1,174.90 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $3,019.95 Typical High $4,365.16 | Professional | 50 · Both sides | $1,778.28 | $3,019.95 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,258.93 Typical High $1,819.70 | Professional | 62 · Two surgeons | $741.31 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $323.59 Typical High $467.74 | Professional | 80 · Assistant surgeon | $190.55 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $281.84 Typical High $407.38 | Professional | AS · PA/NP assist | $165.96 | $281.84 | $407.38 |
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 $1,412.54 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,995.26 | $3,090.30 |
ConnectiCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,238.72 | Professional | None | $2,137.96 | $2,137.96 | $2,238.72 |
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 $1,288.25 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,288.25 | $2,089.30 | $4,168.69 |
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 $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,000.00 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $199.53 | $302.00 | $302.00 |
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 $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $933.25 | $1,412.54 | $1,412.54 |
Where Connecticut sits
The same service costs 5.4 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· 14th of 51
$2,042
AK $4,898TX $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.