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 $2,187.76 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,187.76 | $3,388.44 | $3,388.44 |
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 $1,995.26 Median $3,467.37 Typical High $4,677.35 | Professional | None | $1,995.26 | $3,467.37 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $2,187.76 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,258.93 | $2,187.76 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $549.54 Typical High $776.25 | Professional | 80 · Assistant surgeon | $316.23 | $549.54 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $478.63 Typical High $676.08 | Professional | AS · PA/NP assist | $275.42 | $478.63 | $676.08 |
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 $2,398.83 Median $3,311.31 Typical High $5,128.61 | Professional | None | $2,398.83 | $3,311.31 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,388.44 | $3,801.89 |
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 $2,137.96 Median $3,388.44 Typical High $7,079.46 | Professional | None | $2,137.96 | $3,388.44 | $7,079.46 |
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 $1,122.02 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,122.02 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $446.68 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,698.24 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $338.84 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,344.23 | $2,344.23 |
Where Connecticut sits
The same service costs 5.2 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
$3,467
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.