How much rates vary
Facilitymedian $6,607 · 10th to 90th $912 to $14,454Professionalmedian $2,188 · 10th to 90th $1,259 to $3,631
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 $1,621.81 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,621.81 | $2,398.83 | $2,398.83 |
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 $1,202.26 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,202.26 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,380.38 Typical High $2,041.74 | Professional | 62 · Two surgeons | $758.58 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $354.81 Typical High $524.81 | Professional | 80 · Assistant surgeon | $194.98 | $354.81 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $309.03 Typical High $457.09 | Professional | AS · PA/NP assist | $169.82 | $309.03 | $457.09 |
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 $2,041.74 Median $2,187.76 Typical High $3,890.45 | Professional | None | $2,041.74 | $2,187.76 | $3,890.45 |
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 $1,513.56 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,995.26 | $2,630.27 |
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 $1,122.02 Median $1,995.26 Typical High $4,265.80 | Professional | None | $1,122.02 | $1,995.26 | $4,265.80 |
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 $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $812.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $323.59 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,202.26 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $245.47 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $162.18 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,659.59 | $1,659.59 |
Where Connecticut sits
The same service costs 24.5 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· 18th of 51
$2,188
AK $5,754TX $234
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.