How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $13,490Professionalmedian $1,445 · 10th to 90th $891 to $2,239
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 $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,659.59 | $1,659.59 |
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 $870.96 Median $1,412.54 Typical High $2,089.30 | Professional | None | $870.96 | $1,412.54 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $2,089.30 Typical High $3,162.28 | Professional | 50 · Both sides | $1,318.26 | $2,089.30 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $891.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $549.54 | $891.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $223.87 Typical High $338.84 | Professional | 80 · Assistant surgeon | $141.25 | $223.87 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $194.98 Typical High $295.12 | Professional | AS · PA/NP assist | $123.03 | $194.98 | $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 $1,230.27 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,445.44 | $2,344.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,513.56 | $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 $891.25 Median $1,230.27 Typical High $2,951.21 | Professional | None | $891.25 | $1,230.27 | $2,951.21 |
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 $524.81 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $208.93 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $794.33 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $158.49 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $741.31 | $1,148.15 | $1,148.15 |
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· 12th of 51
$1,549
AK $3,715UT $661
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.