How much rates vary
Facilitymedian $5,888 · 10th to 90th $851 to $14,125Professionalmedian $1,318 · 10th to 90th $955 to $2,399
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 $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,548.82 | $1,548.82 |
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 $954.99 Median $1,318.26 Typical High $2,238.72 | Professional | None | $954.99 | $1,318.26 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $831.76 Typical High $1,348.96 | Professional | 62 · Two surgeons | $602.56 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $213.80 Typical High $346.74 | Professional | 80 · Assistant surgeon | $151.36 | $213.80 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $186.21 Typical High $302.00 | Professional | AS · PA/NP assist | $134.90 | $186.21 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $6,918.31 | Facility | None | $851.14 | $5,623.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,548.82 | $2,570.40 |
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 $1,819.70 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,819.70 | $1,862.09 | $1,862.09 |
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 $954.99 Median $1,348.96 Typical High $2,630.27 | Professional | None | $954.99 | $1,348.96 | $2,630.27 |
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 $512.86 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $512.86 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $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· 29th of 51
$1,413
AK $4,074UT $724
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.