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 $2,290.87 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,290.87 | $3,715.35 | $3,715.35 |
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 $2,041.74 Median $3,548.13 Typical High $5,011.87 | Professional | None | $2,041.74 | $3,548.13 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $2,238.72 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,288.25 | $2,238.72 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $562.34 Typical High $794.33 | Professional | 80 · Assistant surgeon | $331.13 | $562.34 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $489.78 Typical High $691.83 | Professional | AS · PA/NP assist | $288.40 | $489.78 | $691.83 |
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 $2,511.89 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,511.89 | $3,467.37 | $5,370.32 |
ConnectiCare Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,890.45 | Professional | None | $3,467.37 | $3,467.37 | $3,890.45 |
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 $2,238.72 Median $3,388.44 Typical High $7,244.36 | Professional | None | $2,238.72 | $3,388.44 | $7,244.36 |
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 $1,148.15 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,148.15 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $457.09 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,698.24 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $338.84 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $229.09 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,570.40 | $2,570.40 |
Where Connecticut sits
The same service costs 5.4 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· 11th of 51
$3,631
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.