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 $1,479.11 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,479.11 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $16,595.87 Typical High $19,952.62 | Facility | None | $1,000.00 | $16,595.87 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,318.26 | $2,344.23 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,479.11 Typical High $2,089.30 | Professional | 62 · Two surgeons | $812.83 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $380.19 Typical High $524.81 | Professional | 80 · Assistant surgeon | $208.93 | $380.19 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $331.13 Typical High $457.09 | Professional | AS · PA/NP assist | $181.97 | $331.13 | $457.09 |
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 $1,621.81 Median $2,089.30 Typical High $3,467.37 | Professional | None | $1,621.81 | $2,089.30 | $3,467.37 |
ConnectiCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,630.27 | Professional | None | $2,238.72 | $2,238.72 | $2,630.27 |
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 $1,412.54 Median $2,187.76 Typical High $4,677.35 | Professional | None | $1,412.54 | $2,187.76 | $4,677.35 |
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 $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $295.12 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,096.48 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $147.91 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,584.89 | $1,584.89 |
Where Connecticut sits
The same service costs 5.4 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
$2,344
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.