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 $2,041.74 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,041.74 | $3,311.31 | $3,311.31 |
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 $1,819.70 Median $3,162.28 Typical High $4,365.16 | Professional | None | $1,819.70 | $3,162.28 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,995.26 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,096.48 | $1,995.26 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $501.19 Typical High $707.95 | Professional | 80 · Assistant surgeon | $275.42 | $501.19 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $436.52 Typical High $616.60 | Professional | AS · PA/NP assist | $239.88 | $436.52 | $616.60 |
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 $2,754.23 Typical High $4,786.30 | Professional | None | $2,238.72 | $2,754.23 | $4,786.30 |
ConnectiCare Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,467.37 | Professional | None | $3,090.30 | $3,090.30 | $3,467.37 |
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 $1,949.84 Median $3,019.95 Typical High $6,456.54 | Professional | None | $1,949.84 | $3,019.95 | $6,456.54 |
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 $1,000.00 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,000.00 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $407.38 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,513.56 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $302.00 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $204.17 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,290.87 | $2,290.87 |
Where Connecticut sits
The same service costs 6.0 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
$3,162
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.