How much rates vary
Facilitymedian $6,607 · 10th to 90th $851 to $14,125Professionalmedian $1,230 · 10th to 90th $891 to $2,188
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 $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | None | $954.99 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $13,803.84 Typical High $16,218.10 | Facility | None | $954.99 | $13,803.84 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,089.30 | Professional | None | $891.25 | $1,230.27 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $776.25 Typical High $1,288.25 | Professional | 62 · Two surgeons | $562.34 | $776.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $199.53 Typical High $331.13 | Professional | 80 · Assistant surgeon | $141.25 | $199.53 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $173.78 Typical High $288.40 | Professional | AS · PA/NP assist | $125.89 | $173.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,232.93 Typical High $12,589.25 | Facility | None | $851.14 | $10,232.93 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,513.56 | $2,398.83 |
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 $1,584.89 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,584.89 | $1,584.89 | $1,698.24 |
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 $891.25 Median $1,258.93 Typical High $2,454.71 | Professional | None | $891.25 | $1,258.93 | $2,454.71 |
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 $478.63 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $478.63 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $190.55 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $95.50 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $676.08 | $1,023.29 | $1,023.29 |
Where Connecticut sits
The same service costs 6.3 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
$1,318
OK $4,169UT $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.