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 $3,890.45 Median $6,456.54 Typical High $6,456.54 | Professional | None | $3,890.45 | $6,456.54 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $7,943.28 | Professional | None | $3,388.44 | $5,370.32 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,137.96 Median $3,311.31 Typical High $5,011.87 | Professional | 62 · Two surgeons | $2,137.96 | $3,311.31 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $831.76 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $537.03 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $724.44 Typical High $1,122.02 | Professional | AS · PA/NP assist | $478.63 | $724.44 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $4,897.79 Typical High $7,943.28 | Professional | None | $2,238.72 | $4,897.79 | $7,943.28 |
ConnectiCare Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,606.93 | Professional | None | $5,623.41 | $5,623.41 | $6,606.93 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $4,677.35 Typical High $9,772.37 | Professional | None | $2,754.23 | $4,677.35 | $9,772.37 |
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 $1,949.84 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $1,949.84 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $776.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $2,884.03 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $575.44 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $389.05 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $2,691.53 | $4,570.88 | $4,570.88 |
Where Connecticut sits
The same service costs 10.7 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· 14th of 51
$5,248
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.