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 $6,760.83 Typical High $35,481.34 | Facility | None | $4,365.16 | $6,760.83 | $35,481.34 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,288.25 | Professional | None | $851.14 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $13,803.84 Typical High $83,176.38 | Facility | None | $6,309.57 | $13,803.84 | $83,176.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,412.54 Typical High $1,905.46 | Professional | None | $776.25 | $1,412.54 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $478.63 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $223.87 Typical High $309.03 | Professional | 80 · Assistant surgeon | $123.03 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $194.98 Typical High $269.15 | Professional | AS · PA/NP assist | $107.15 | $194.98 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,380.38 Typical High $63,095.73 | Facility | None | $512.86 | $1,380.38 | $63,095.73 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,995.26 | Professional | None | $933.25 | $1,288.25 | $1,995.26 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,288.25 | $1,548.82 |
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 $812.83 Median $1,288.25 Typical High $2,691.53 | Professional | None | $812.83 | $1,288.25 | $2,691.53 |
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 $426.58 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $426.58 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $169.82 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $85.11 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $602.56 | $891.25 | $891.25 |
Where Connecticut sits
The same service costs 4.6 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
$1,413
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.