How much rates vary
Facilitymedian $6,166 · 10th to 90th $933 to $12,303Professionalmedian $1,259 · 10th to 90th $912 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 $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 $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | None | $977.24 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,481.54 Typical High $13,489.63 | Facility | None | $933.25 | $11,481.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,137.96 | Professional | None | $912.01 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $794.33 Typical High $1,318.26 | Professional | 62 · Two surgeons | $575.44 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $204.17 Typical High $338.84 | Professional | 80 · Assistant surgeon | $147.91 | $204.17 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $177.83 Typical High $295.12 | Professional | AS · PA/NP assist | $128.82 | $177.83 | $295.12 |
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 $1,318.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,513.56 | $2,454.71 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $3,019.95 | Facility | None | $512.86 | $707.95 | $3,019.95 |
ConnectiCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,584.89 | $1,737.80 |
Health New England Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,511.89 | Professional | None | $912.01 | $1,288.25 | $2,511.89 |
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 $489.78 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $489.78 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $199.53 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $691.83 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 5.9 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· 30th of 51
$1,349
OK $4,074UT $692
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.