How much rates vary
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,290.87 | $3,090.30 | $3,090.30 |
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 $1,995.26 Median $2,691.53 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,691.53 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,698.24 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,258.93 | $1,698.24 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $436.52 Typical High $549.54 | Professional | 80 · Assistant surgeon | $323.59 | $436.52 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $380.19 Typical High $478.63 | Professional | AS · PA/NP assist | $281.84 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $3,311.31 | Facility | None | $1,000.00 | $2,398.83 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,951.21 | $3,235.94 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,090.30 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,495.41 | Professional | None | $2,137.96 | $3,311.31 | $5,495.41 |
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 $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,148.15 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $457.09 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,737.80 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $346.74 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $229.09 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,137.96 | $2,137.96 |
Where Connecticut sits
The same service costs 15.8 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· 24th of 51
$2,951
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.