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 $2,238.72 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,238.72 | $3,311.31 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $17,378.01 Typical High $25,703.96 | Facility | None | $3,715.35 | $17,378.01 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $3,801.89 Typical High $5,011.87 | Professional | None | $1,995.26 | $3,801.89 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $2,344.23 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,258.93 | $2,344.23 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $602.56 Typical High $794.33 | Professional | 80 · Assistant surgeon | $316.23 | $602.56 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $524.81 Typical High $691.83 | Professional | AS · PA/NP assist | $281.84 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $19,054.61 Typical High $23,442.29 | Facility | None | $851.14 | $19,054.61 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,548.13 Typical High $5,011.87 | Professional | None | $3,090.30 | $3,548.13 | $5,011.87 |
ConnectiCare Setting Professional Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $3,801.89 | Professional | None | $2,398.83 | $3,311.31 | $3,801.89 |
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 $1,698.24 Median $3,162.28 Typical High $5,888.44 | Professional | None | $1,698.24 | $3,162.28 | $5,888.44 |
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 $1,122.02 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,122.02 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $457.09 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,698.24 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $223.87 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,344.23 | $2,344.23 |
Where Connecticut sits
The same service costs 6.5 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· 19th of 51
$3,311
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.