How much rates vary
Facilitymedian $6,607 · 10th to 90th $912 to $14,454Professionalmedian $2,042 · 10th to 90th $1,175 to $3,311
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 $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,238.72 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,122.02 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,258.93 Typical High $1,737.80 | Professional | 62 · Two surgeons | $707.95 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $316.23 Typical High $446.68 | Professional | 80 · Assistant surgeon | $177.83 | $316.23 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $281.84 Typical High $389.05 | Professional | AS · PA/NP assist | $158.49 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $8,511.38 Typical High $10,715.19 | Facility | None | $851.14 | $8,511.38 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,862.09 | $1,995.26 | $3,630.78 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,621.81 | $2,344.23 |
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 $1,047.13 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,047.13 | $1,819.70 | $3,890.45 |
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 $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $302.00 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,122.02 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $223.87 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 11.0 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· 19th of 51
$2,042
AK $5,370TX $490
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.