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 $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $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 $1,023.29 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,819.70 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $1,122.02 Typical High $1,698.24 | Professional | 62 · Two surgeons | $630.96 | $1,122.02 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $281.84 Typical High $426.58 | Professional | 80 · Assistant surgeon | $162.18 | $281.84 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $251.19 Typical High $371.54 | Professional | AS · PA/NP assist | $141.25 | $251.19 | $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 $1,584.89 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,819.70 | $2,344.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,659.59 | $2,041.74 |
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 $870.96 Median $1,584.89 Typical High $3,090.30 | Professional | None | $870.96 | $1,584.89 | $3,090.30 |
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 $602.56 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $602.56 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $239.88 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $912.01 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $120.23 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $851.14 | $1,230.27 | $1,230.27 |
Where Connecticut sits
The same service costs 7.9 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· 12th of 51
$1,778
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.