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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,884.03 | $2,884.03 |
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 $3,548.13 Typical High $4,677.35 | Professional | None | $2,089.30 | $3,548.13 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $2,187.76 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,318.26 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $562.34 Typical High $758.58 | Professional | 80 · Assistant surgeon | $338.84 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $489.78 Typical High $660.69 | Professional | AS · PA/NP assist | $295.12 | $489.78 | $660.69 |
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 $2,754.23 Median $3,019.95 Typical High $5,128.61 | Professional | None | $2,754.23 | $3,019.95 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,951.21 | $3,311.31 |
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 $1,621.81 Median $3,162.28 Typical High $6,165.95 | Professional | None | $1,621.81 | $3,162.28 | $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 $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,047.13 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $416.87 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,548.82 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $316.23 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $208.93 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,041.74 | $2,041.74 |
Where Connecticut sits
The same service costs 21.4 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
$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.