How much rates vary
Facilitymedian $6,166 · 10th to 90th $912 to $14,125Professionalmedian $1,820 · 10th to 90th $1,318 to $3,388
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 $1,445.44 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,445.44 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,819.70 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,148.15 Typical High $1,949.84 | Professional | 62 · Two surgeons | $831.76 | $1,148.15 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $295.12 Typical High $489.78 | Professional | 80 · Assistant surgeon | $213.80 | $295.12 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $257.04 Typical High $426.58 | Professional | AS · PA/NP assist | $186.21 | $257.04 | $426.58 |
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 $1,905.46 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,187.76 | $3,548.13 |
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 $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,511.89 | $2,630.27 | $2,630.27 |
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 $1,318.26 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,318.26 | $1,862.09 | $3,630.78 |
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 $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $288.40 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,071.52 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $213.80 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,513.56 | $1,513.56 |
Where Connecticut sits
The same service costs 5.8 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· 30th of 51
$1,995
AK $5,623UT $977
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.