How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $18,621Professionalmedian $1,585 · 10th to 90th $977 to $2,630
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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $15,135.61 Typical High $25,703.96 | Facility | None | $7,079.46 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,454.71 Typical High $3,235.94 | Professional | 50 · Both sides | $1,513.56 | $2,454.71 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $1,023.29 Typical High $1,380.38 | Professional | 62 · Two surgeons | $630.96 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $257.04 Typical High $346.74 | Professional | 80 · Assistant surgeon | $158.49 | $257.04 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $229.09 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $229.09 | $302.00 |
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 $1,148.15 Median $1,318.26 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,318.26 | $2,818.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,202.26 | $1,479.11 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $3,311.31 | Professional | None | $831.76 | $1,445.44 | $3,311.31 |
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 $562.34 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $562.34 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $851.14 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $169.82 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $794.33 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 21.9 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
$1,585
AK $4,467TX $204
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.