How much rates vary
Facilitymedian $4,169 · 10th to 90th $891 to $8,710Professionalmedian $912 · 10th to 90th $661 to $1,622
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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | None | $707.95 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,584.89 | Professional | None | $660.69 | $912.01 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,380.38 Typical High $2,344.23 | Professional | 50 · Both sides | $977.24 | $1,380.38 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $575.44 Typical High $977.24 | Professional | 62 · Two surgeons | $416.87 | $575.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $141.25 Typical High $251.19 | Professional | 80 · Assistant surgeon | $104.71 | $141.25 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $128.82 Typical High $218.78 | Professional | AS · PA/NP assist | $91.20 | $128.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $2,754.23 | Facility | None | $851.14 | $2,137.96 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,737.80 | Professional | None | $912.01 | $1,047.13 | $1,737.80 |
ConnectiCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,096.48 | $1,230.27 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,778.28 | Professional | None | $645.65 | $851.14 | $1,778.28 |
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 $354.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $354.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $70.79 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 6.0 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
$955
OK $2,884UT $479
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.