How much rates vary
Facilitymedian $5,623 · 10th to 90th $912 to $12,303Professionalmedian $2,042 · 10th to 90th $1,096 to $2,951
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 $1,445.44 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,949.84 | $1,949.84 |
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 $1,174.90 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,174.90 | $2,137.96 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $3,162.28 Typical High $3,890.45 | Professional | 50 · Both sides | $1,698.24 | $3,162.28 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,318.26 Typical High $1,621.81 | Professional | 62 · Two surgeons | $707.95 | $1,318.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $338.84 Typical High $416.87 | Professional | 80 · Assistant surgeon | $181.97 | $338.84 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $295.12 Typical High $363.08 | Professional | AS · PA/NP assist | $158.49 | $295.12 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,570.88 Typical High $6,025.60 | Facility | None | $1,000.00 | $4,570.88 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,584.89 | $3,019.95 |
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 $870.96 Median $1,445.44 Typical High $2,041.74 | Professional | None | $870.96 | $1,445.44 | $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 $1,122.02 Median $1,548.82 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,548.82 | $4,168.69 |
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 $724.44 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $724.44 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $288.40 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,071.52 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $144.54 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $1,348.96 |
Where Connecticut sits
The same service costs 7.1 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· 16th of 51
$2,042
AK $5,370UT $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.