How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,096 to $15,849Professionalmedian $1,096 · 10th to 90th $692 to $1,660
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | None | $676.08 | $1,047.13 | $1,047.13 |
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 $660.69 Median $1,071.52 Typical High $1,548.82 | Professional | None | $660.69 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,584.89 Typical High $2,344.23 | Professional | 50 · Both sides | $977.24 | $1,584.89 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $165.96 Typical High $245.47 | Professional | 80 · Assistant surgeon | $104.71 | $165.96 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $147.91 Typical High $218.78 | Professional | AS · PA/NP assist | $91.20 | $147.91 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,659.59 | Professional | None | $977.24 | $1,202.26 | $1,659.59 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,318.26 | $1,318.26 |
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 $776.25 Median $1,071.52 Typical High $2,238.72 | Professional | None | $776.25 | $1,071.52 | $2,238.72 |
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 $363.08 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $512.86 | $741.31 | $741.31 |
Where Connecticut sits
The same service costs 6.5 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· 25th of 51
$1,122
AK $3,467UT $537
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.