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 $8,511.38 Typical High $11,481.54 | Facility | None | $4,570.88 | $8,511.38 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,187.76 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $26,302.68 Typical High $45,708.82 | Facility | None | $6,760.83 | $26,302.68 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $3,467.37 Typical High $4,897.79 | Professional | None | $1,862.09 | $3,467.37 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $2,187.76 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,148.15 | $2,187.76 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $562.34 Typical High $794.33 | Professional | 80 · Assistant surgeon | $288.40 | $562.34 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $489.78 Typical High $691.83 | Professional | AS · PA/NP assist | $257.04 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $19,498.45 Typical High $23,988.33 | Facility | None | $851.14 | $19,498.45 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,677.35 | Professional | None | $2,570.40 | $2,951.21 | $4,677.35 |
ConnectiCare Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,570.40 | $2,818.38 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $18,197.01 | Facility | None | $1,348.96 | $9,549.93 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $5,370.32 | Professional | None | $1,513.56 | $2,818.38 | $5,370.32 |
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 $1,096.48 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,096.48 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $436.52 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,621.81 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $323.59 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $218.78 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,089.30 | $2,089.30 |
Where Connecticut sits
The same service costs 16.2 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
$3,388
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.