How much rates vary
Facilitymedian $6,607 · 10th to 90th $912 to $14,454Professionalmedian $2,138 · 10th to 90th $1,230 to $3,467
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 $1,548.82 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,548.82 | $2,454.71 | $2,454.71 |
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 $1,174.90 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,174.90 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,318.26 Typical High $1,819.70 | Professional | 62 · Two surgeons | $741.31 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $331.13 Typical High $457.09 | Professional | 80 · Assistant surgeon | $186.21 | $331.13 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $288.40 Typical High $407.38 | Professional | AS · PA/NP assist | $162.18 | $288.40 | $407.38 |
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 $1,995.26 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,137.96 | $3,715.35 |
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 $1,479.11 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,905.46 | $2,398.83 |
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 $1,071.52 Median $1,905.46 Typical High $4,073.80 | Professional | None | $1,071.52 | $1,905.46 | $4,073.80 |
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 $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $776.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $309.03 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,148.15 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $234.42 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,737.80 | $1,737.80 |
Where Connecticut sits
The same service costs 7.2 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· 17th of 51
$2,138
AK $5,495TX $759
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.