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 $1,905.46 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,951.21 | $2,951.21 |
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 $1,698.24 Median $3,019.95 Typical High $4,073.80 | Professional | None | $1,698.24 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,905.46 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,071.52 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $489.78 Typical High $676.08 | Professional | 80 · Assistant surgeon | $275.42 | $489.78 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $426.58 Typical High $588.84 | Professional | AS · PA/NP assist | $239.88 | $426.58 | $588.84 |
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 $2,089.30 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,884.03 | $4,466.84 |
ConnectiCare Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,884.03 | $2,884.03 | $3,388.44 |
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 $1,862.09 Median $2,951.21 Typical High $6,025.60 | Professional | None | $1,862.09 | $2,951.21 | $6,025.60 |
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 $954.99 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $954.99 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $380.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,445.44 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $288.40 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $190.55 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,041.74 | $2,041.74 |
Where Connecticut sits
The same service costs 5.9 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· 13th of 51
$3,020
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.