How much rates vary
Facilitymedian $5,495 · 10th to 90th $871 to $14,125Professionalmedian $1,380 · 10th to 90th $832 to $1,995
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 $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $1,949.84 | Professional | None | $794.33 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $831.76 Typical High $1,230.27 | Professional | 62 · Two surgeons | $501.19 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $213.80 Typical High $309.03 | Professional | 80 · Assistant surgeon | $125.89 | $213.80 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $186.21 Typical High $275.42 | Professional | AS · PA/NP assist | $109.65 | $186.21 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,623.41 Typical High $6,918.31 | Facility | None | $741.31 | $5,623.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,348.96 | $2,187.76 |
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 $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,412.54 | $1,548.82 |
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 $851.14 Median $1,148.15 Typical High $2,754.23 | Professional | None | $851.14 | $1,148.15 | $2,754.23 |
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 $501.19 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $501.19 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $741.31 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $147.91 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $100.00 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $691.83 | $1,096.48 | $1,096.48 |
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· 17th of 51
$1,549
AK $3,548UT $631
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.