How much rates vary
Facilitymedian $4,169 · 10th to 90th $871 to $8,710Professionalmedian $1,820 · 10th to 90th $1,023 to $2,884
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,000.00 | $2,187.76 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,380.38 Typical High $1,819.70 | Professional | 62 · Two surgeons | $616.60 | $1,380.38 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $346.74 Typical High $467.74 | Professional | 80 · Assistant surgeon | $154.88 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $302.00 Typical High $407.38 | Professional | AS · PA/NP assist | $138.04 | $302.00 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $3,630.78 | Facility | None | $741.31 | $2,951.21 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,479.11 | $2,344.23 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,659.59 | $1,778.28 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $3,801.89 | Professional | None | $977.24 | $1,584.89 | $3,801.89 |
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 $537.03 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $537.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $812.83 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $162.18 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $107.15 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $758.58 | $1,148.15 | $1,148.15 |
Where Connecticut sits
The same service costs 5.2 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· 13th of 51
$1,820
AK $3,981TX $759
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.