How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $11,749Professionalmedian $631 · 10th to 90th $398 to $1,072
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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | None | $398.11 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,481.54 Typical High $13,489.63 | Facility | None | $2,754.23 | $11,481.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $1,122.02 | Professional | None | $416.87 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $1,258.93 Typical High $1,659.59 | Professional | 50 · Both sides | $616.60 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $524.81 Typical High $707.95 | Professional | 62 · Two surgeons | $257.04 | $524.81 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $134.90 Typical High $177.83 | Professional | 80 · Assistant surgeon | $64.57 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $117.49 Typical High $154.88 | Professional | AS · PA/NP assist | $57.54 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,630.78 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $891.25 | Professional | None | $501.19 | $549.54 | $891.25 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $707.95 | Professional | None | $512.86 | $630.96 | $707.95 |
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 $363.08 Median $645.65 Typical High $1,412.54 | Professional | None | $363.08 | $645.65 | $1,412.54 |
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 $199.53 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $199.53 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $302.00 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $60.26 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $39.81 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $281.84 | $389.05 | $389.05 |
Where Connecticut sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 16th of 51
$646
AK $1,660UT $295
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.