How much rates vary
Facilitymedian $6,166 · 10th to 90th $759 to $13,490Professionalmedian $1,479 · 10th to 90th $912 to $2,291
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $11,748.98 Typical High $13,803.84 | Facility | None | $3,981.07 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,445.44 Typical High $2,137.96 | Professional | None | $891.25 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,137.96 Typical High $3,162.28 | Professional | 50 · Both sides | $1,348.96 | $2,137.96 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $891.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $562.34 | $891.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $229.09 Typical High $338.84 | Professional | 80 · Assistant surgeon | $141.25 | $229.09 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $199.53 Typical High $295.12 | Professional | AS · PA/NP assist | $125.89 | $199.53 | $295.12 |
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 $1,288.25 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,479.11 | $2,398.83 |
ConnectiCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,548.82 | $1,548.82 | $1,659.59 |
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 $912.01 Median $1,258.93 Typical High $3,019.95 | Professional | None | $912.01 | $1,258.93 | $3,019.95 |
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 $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $537.03 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $213.80 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $794.33 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $162.18 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $107.15 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $741.31 | $1,230.27 | $1,230.27 |
Where Connecticut sits
The same service costs 6.6 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
$1,622
AK $3,802TX $575
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.