How much rates vary
Facilitymedian $4,786 · 10th to 90th $759 to $11,749Professionalmedian $661 · 10th to 90th $479 to $1,122
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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | None | $512.86 | $776.25 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,047.13 | Professional | None | $457.09 | $660.69 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,000.00 Typical High $1,513.56 | Professional | 50 · Both sides | $691.83 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $416.87 Typical High $645.65 | Professional | 62 · Two surgeons | $288.40 | $416.87 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $107.15 Typical High $162.18 | Professional | 80 · Assistant surgeon | $72.44 | $107.15 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $93.33 Typical High $141.25 | Professional | AS · PA/NP assist | $64.57 | $93.33 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,548.13 Typical High $4,365.16 | Facility | None | $549.54 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
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 $467.74 Median $645.65 Typical High $1,288.25 | Professional | None | $467.74 | $645.65 | $1,288.25 |
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 $257.04 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $257.04 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $380.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $354.81 | $537.03 | $537.03 |
Where Connecticut sits
The same service costs 5.5 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
$741
AK $2,042UT $372
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.