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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,778.28 | $1,778.28 |
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 $1,174.90 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,174.90 | $2,187.76 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,380.38 Typical High $1,905.46 | Professional | 62 · Two surgeons | $741.31 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $346.74 Typical High $478.63 | Professional | 80 · Assistant surgeon | $186.21 | $346.74 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $302.00 Typical High $426.58 | Professional | AS · PA/NP assist | $162.18 | $302.00 | $426.58 |
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 $1,778.28 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,041.74 | $2,818.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,862.09 | $2,290.87 |
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 $977.24 Median $1,778.28 Typical High $3,388.44 | Professional | None | $977.24 | $1,778.28 | $3,388.44 |
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 $251.19 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $251.19 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $933.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $186.21 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $125.89 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $870.96 | $1,230.27 | $1,230.27 |
Where Connecticut sits
The same service costs 14.5 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· 20th of 51
$1,905
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.