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 $2,754.23 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,754.23 | $3,981.07 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $4,570.88 Typical High $6,025.60 | Professional | None | $2,398.83 | $4,570.88 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $2,818.38 Typical High $3,801.89 | Professional | 62 · Two surgeons | $1,479.11 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $724.44 Typical High $977.24 | Professional | 80 · Assistant surgeon | $371.54 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $630.96 Typical High $851.14 | Professional | AS · PA/NP assist | $323.59 | $630.96 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,549.93 Typical High $12,022.64 | Facility | None | $851.14 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $4,265.80 Typical High $6,025.60 | Professional | None | $3,890.45 | $4,265.80 | $6,025.60 |
ConnectiCare Setting Professional Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $4,570.88 | Professional | None | $2,951.21 | $4,073.80 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,801.89 Typical High $7,079.46 | Professional | None | $2,089.30 | $3,801.89 | $7,079.46 |
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 $1,380.38 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,380.38 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,089.30 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $416.87 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $275.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,818.38 | $2,818.38 |
Where Connecticut sits
The same service costs 8.7 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· 15th of 51
$4,074
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.