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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $776.25 | $1,148.15 | $1,148.15 |
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 $691.83 Median $954.99 Typical High $1,288.25 | Professional | None | $691.83 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $602.56 Typical High $758.58 | Professional | 62 · Two surgeons | $436.52 | $602.56 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $154.88 Typical High $194.98 | Professional | 80 · Assistant surgeon | $109.65 | $154.88 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $134.90 Typical High $169.82 | Professional | AS · PA/NP assist | $97.72 | $134.90 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,398.83 Typical High $3,090.30 | Facility | None | $851.14 | $2,398.83 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,737.80 | Professional | None | $977.24 | $1,023.29 | $1,737.80 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,071.52 | $1,071.52 |
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 $741.31 Median $1,122.02 Typical High $1,819.70 | Professional | None | $741.31 | $1,122.02 | $1,819.70 |
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 $389.05 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $389.05 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $154.88 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $77.62 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $549.54 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 7.6 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· 31st of 51
$1,023
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.