How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,288 to $16,596Professionalmedian $575 · 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 $8,511.38 Typical High $11,481.54 | Facility | None | $4,570.88 | $8,511.38 | $11,481.54 |
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 $3,235.94 Median $15,135.61 Typical High $17,782.79 | Facility | None | $3,235.94 | $15,135.61 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $891.25 | Professional | None | $398.11 | $575.44 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $870.96 Typical High $1,318.26 | Professional | 50 · Both sides | $575.44 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $363.08 Typical High $549.54 | Professional | 62 · Two surgeons | $239.88 | $363.08 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $93.33 Typical High $138.04 | Professional | 80 · Assistant surgeon | $61.66 | $93.33 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $79.43 Typical High $123.03 | Professional | AS · PA/NP assist | $53.70 | $79.43 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $6,456.54 Typical High $8,317.64 | Facility | None | $1,905.46 | $6,456.54 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,096.48 | Professional | None | $549.54 | $660.69 | $1,096.48 |
ConnectiCare Setting Facility Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,348.96 | $1,862.09 | $2,187.76 |
ConnectiCare Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | None | $691.83 | $691.83 | $794.33 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
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 9.5 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
$661
OK $3,236UT $339
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.