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 $2,398.83 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,398.83 | $3,311.31 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $5,370.32 | Professional | None | $2,089.30 | $3,981.07 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $2,454.71 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,318.26 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $630.96 Typical High $851.14 | Professional | 80 · Assistant surgeon | $338.84 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $549.54 Typical High $758.58 | Professional | AS · PA/NP assist | $295.12 | $549.54 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,762.47 Typical High $9,772.37 | Facility | None | $851.14 | $7,762.47 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $5,248.07 | Professional | None | $3,311.31 | $3,801.89 | $5,248.07 |
ConnectiCare Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,398.83 | $3,235.94 | $3,981.07 |
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 $1,819.70 Median $3,388.44 Typical High $6,165.95 | Professional | None | $1,819.70 | $3,388.44 | $6,165.95 |
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 $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,174.90 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $478.63 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,778.28 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $354.81 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,344.23 | $2,344.23 |
Where Connecticut sits
The same service costs 21.9 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
$3,467
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.