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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,230.27 Typical High $1,698.24 | Professional | 62 · Two surgeons | $676.08 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $316.23 Typical High $426.58 | Professional | 80 · Assistant surgeon | $169.82 | $316.23 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $151.36 | $275.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,165.95 Typical High $7,762.47 | Facility | None | $851.14 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,995.26 | $2,630.27 |
ConnectiCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,778.28 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,737.80 Typical High $3,162.28 | Professional | None | $933.25 | $1,737.80 | $3,162.28 |
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 $616.60 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $616.60 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $245.47 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $933.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $870.96 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 16.6 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· 19th of 51
$1,820
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.