How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,072 · 10th to 90th $776 to $1,905
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 $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | None | $831.76 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,819.70 | Professional | None | $776.25 | $1,071.52 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $676.08 Typical High $1,122.02 | Professional | 62 · Two surgeons | $489.78 | $676.08 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $173.78 Typical High $281.84 | Professional | 80 · Assistant surgeon | $125.89 | $173.78 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $109.65 | $151.36 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $4,365.16 | Facility | None | $851.14 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,288.25 | $2,089.30 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,380.38 | $1,479.11 |
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 $776.25 Median $1,071.52 Typical High $2,137.96 | Professional | None | $776.25 | $1,071.52 | $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 $416.87 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $416.87 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $630.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $125.89 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $83.18 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $588.84 | $933.25 | $933.25 |
Where Connecticut sits
The same service costs 6.6 times more in Oklahoma 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· 31st of 51
$1,148
OK $3,802UT $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.