How much rates vary
Facilitymedian $6,607 · 10th to 90th $912 to $16,596Professionalmedian $1,000 · 10th to 90th $692 to $1,738
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,000.00 | Professional | None | $691.83 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $14,454.40 Typical High $19,498.45 | Facility | None | $5,754.40 | $14,454.40 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,621.81 | Professional | None | $660.69 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,548.82 Typical High $2,398.83 | Professional | 50 · Both sides | $977.24 | $1,548.82 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $676.08 Typical High $1,000.00 | Professional | 62 · Two surgeons | $407.38 | $676.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $173.78 Typical High $257.04 | Professional | 80 · Assistant surgeon | $107.15 | $173.78 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $151.36 Typical High $223.87 | Professional | AS · PA/NP assist | $91.20 | $151.36 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,584.89 | Professional | None | $933.25 | $1,148.15 | $1,584.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,318.26 | $1,318.26 |
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 $741.31 Median $1,023.29 Typical High $2,137.96 | Professional | None | $741.31 | $1,023.29 | $2,137.96 |
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 $346.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $478.63 | $707.95 | $707.95 |
Where Connecticut sits
The same service costs 6.9 times more in Alaska than in Texas. 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· 15th of 51
$1,122
AK $2,884TX $417
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.