How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $11,749Professionalmedian $1,047 · 10th to 90th $589 to $1,622
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 $602.56 Median $794.33 Typical High $794.33 | Professional | None | $602.56 | $794.33 | $794.33 |
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 $602.56 Median $1,258.93 Typical High $1,659.59 | Professional | None | $602.56 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,862.09 Typical High $2,511.89 | Professional | 50 · Both sides | $912.01 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $380.19 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $199.53 Typical High $269.15 | Professional | 80 · Assistant surgeon | $95.50 | $199.53 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $85.11 | $173.78 | $234.42 |
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 $741.31 Median $831.76 Typical High $1,348.96 | Professional | None | $741.31 | $831.76 | $1,348.96 |
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 $758.58 Median $954.99 Typical High $1,047.13 | Professional | None | $758.58 | $954.99 | $1,047.13 |
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 $549.54 Median $954.99 Typical High $2,137.96 | Professional | None | $549.54 | $954.99 | $2,137.96 |
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 $302.00 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $562.34 | $562.34 |
Where Connecticut sits
The same service costs 5.9 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
$1,047
AK $2,512TX $427
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.