How much rates vary
Facilitymedian $5,495 · 10th to 90th $912 to $12,303Professionalmedian $2,089 · 10th to 90th $1,148 to $3,020
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 $1,479.11 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,202.26 | $2,137.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $3,235.94 Typical High $3,890.45 | Professional | 50 · Both sides | $1,737.80 | $3,235.94 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $346.74 Typical High $416.87 | Professional | 80 · Assistant surgeon | $186.21 | $346.74 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $302.00 Typical High $363.08 | Professional | AS · PA/NP assist | $162.18 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,630.78 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,659.59 | $3,090.30 |
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 $891.25 Median $1,479.11 Typical High $2,041.74 | Professional | None | $891.25 | $1,479.11 | $2,041.74 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $4,265.80 | Professional | None | $1,174.90 | $1,584.89 | $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 $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $741.31 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $295.12 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $223.87 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $1,380.38 |
Where Connecticut sits
The same service costs 7.4 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· 15th of 51
$2,089
AK $5,623UT $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.