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 $1,000.00 Median $16,595.87 Typical High $19,952.62 | Facility | None | $1,000.00 | $16,595.87 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $4,786.30 | Professional | None | $1,949.84 | $3,388.44 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $2,137.96 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,230.27 | $2,137.96 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $537.03 Typical High $758.58 | Professional | 80 · Assistant surgeon | $309.03 | $537.03 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $478.63 Typical High $660.69 | Professional | AS · PA/NP assist | $269.15 | $478.63 | $660.69 |
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 $2,344.23 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,344.23 | $3,235.94 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,801.89 | Professional | None | $3,235.94 | $3,235.94 | $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 $2,089.30 Median $3,235.94 Typical High $6,918.31 | Professional | None | $2,089.30 | $3,235.94 | $6,918.31 |
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 $1,071.52 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,071.52 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $436.52 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,621.81 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,290.87 | $2,290.87 |
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
$3,388
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.