How much rates vary
Facilitymedian $6,166 · 10th to 90th $977 to $15,136Professionalmedian $1,660 · 10th to 90th $933 to $2,570
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,659.59 Typical High $2,187.76 | Professional | None | $891.25 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $1,000.00 Typical High $1,380.38 | Professional | 62 · Two surgeons | $562.34 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $141.25 | $257.04 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $223.87 Typical High $309.03 | Professional | AS · PA/NP assist | $123.03 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $13,489.63 Typical High $16,982.44 | Facility | None | $741.31 | $13,489.63 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,621.81 | $2,818.38 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,513.56 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,479.11 Typical High $3,090.30 | Professional | None | $812.83 | $1,479.11 | $3,090.30 |
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 $588.84 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $234.42 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $891.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $177.83 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $117.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $831.76 | $1,202.26 | $1,202.26 |
Where Connecticut sits
The same service costs 6.2 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· 17th of 51
$1,660
AK $4,266UT $692
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.