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 $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | None | $676.08 | $1,000.00 | $1,000.00 |
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 $602.56 Median $851.14 Typical High $1,122.02 | Professional | None | $602.56 | $851.14 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $524.81 Typical High $676.08 | Professional | 62 · Two surgeons | $380.19 | $524.81 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $134.90 Typical High $169.82 | Professional | 80 · Assistant surgeon | $97.72 | $134.90 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $85.11 | $117.49 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,981.07 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,981.07 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,513.56 | Professional | None | $891.25 | $933.25 | $1,513.56 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | None | $954.99 | $977.24 | $977.24 |
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 $645.65 Median $977.24 Typical High $1,584.89 | Professional | None | $645.65 | $977.24 | $1,584.89 |
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 $338.84 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $512.86 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $102.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $67.61 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $478.63 | $691.83 | $691.83 |
Where Connecticut sits
The same service costs 8.1 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· 33rd of 51
$912
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.