How much rates vary
Facilitymedian $6,310 · 10th to 90th $871 to $11,749Professionalmedian $589 · 10th to 90th $417 to $955
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 $446.68 Median $660.69 Typical High $660.69 | Professional | None | $446.68 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $891.25 | Professional | None | $398.11 | $588.84 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $851.14 Typical High $1,318.26 | Professional | 50 · Both sides | $575.44 | $851.14 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $354.81 Typical High $549.54 | Professional | 62 · Two surgeons | $239.88 | $354.81 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $93.33 Typical High $141.25 | Professional | 80 · Assistant surgeon | $61.66 | $93.33 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $81.28 Typical High $123.03 | Professional | AS · PA/NP assist | $53.70 | $81.28 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,918.31 Typical High $8,511.38 | Facility | None | $1,000.00 | $6,918.31 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,096.48 | Professional | None | $549.54 | $676.08 | $1,096.48 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | None | $707.95 | $707.95 | $794.33 |
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 $407.38 Median $537.03 Typical High $1,122.02 | Professional | None | $407.38 | $537.03 | $1,122.02 |
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 $218.78 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $89.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $331.13 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $66.07 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $44.67 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $309.03 | $467.74 | $467.74 |
Where Connecticut sits
The same service costs 9.8 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
$646
OK $3,236UT $331
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.