How much rates vary
Facilitymedian $4,169 · 10th to 90th $891 to $9,120Professionalmedian $1,479 · 10th to 90th $851 to $2,138
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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,041.74 | Professional | None | $891.25 | $1,584.89 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,398.83 Typical High $3,019.95 | Professional | 50 · Both sides | $1,348.96 | $2,398.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $251.19 Typical High $323.59 | Professional | 80 · Assistant surgeon | $144.54 | $251.19 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $223.87 Typical High $281.84 | Professional | AS · PA/NP assist | $125.89 | $223.87 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,630.27 Typical High $3,801.89 | Facility | None | $1,000.00 | $2,630.27 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,238.72 | Professional | None | $851.14 | $1,230.27 | $2,238.72 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,584.89 | Professional | None | $630.96 | $1,023.29 | $1,584.89 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $3,235.94 | Professional | None | $851.14 | $1,174.90 | $3,235.94 |
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 $575.44 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $575.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $229.09 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $851.14 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $169.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $114.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $794.33 | $1,071.52 | $1,071.52 |
Where Connecticut sits
The same service costs 7.2 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· 14th of 51
$1,549
AK $3,981UT $550
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.