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 $3,235.94 Typical High $3,235.94 | Professional | None | $2,041.74 | $3,235.94 | $3,235.94 |
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 $1,905.46 Median $3,311.31 Typical High $4,466.84 | Professional | None | $1,905.46 | $3,311.31 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $2,089.30 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,202.26 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $524.81 Typical High $741.31 | Professional | 80 · Assistant surgeon | $302.00 | $524.81 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $457.09 Typical High $645.65 | Professional | AS · PA/NP assist | $263.03 | $457.09 | $645.65 |
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 $2,290.87 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,162.28 | $4,897.79 |
ConnectiCare Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,630.78 | Professional | None | $3,235.94 | $3,235.94 | $3,630.78 |
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 $2,041.74 Median $3,162.28 Typical High $6,606.93 | Professional | None | $2,041.74 | $3,162.28 | $6,606.93 |
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 $1,047.13 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,047.13 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $416.87 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,584.89 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $316.23 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $208.93 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,238.72 | $2,238.72 |
Where Connecticut sits
The same service costs 5.8 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
$3,311
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.