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 $2,344.23 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,344.23 | $3,801.89 | $3,801.89 |
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 $2,089.30 Median $3,630.78 Typical High $5,011.87 | Professional | None | $2,089.30 | $3,630.78 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $2,290.87 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,258.93 | $2,290.87 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $575.44 Typical High $812.83 | Professional | 80 · Assistant surgeon | $316.23 | $575.44 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $501.19 Typical High $707.95 | Professional | AS · PA/NP assist | $275.42 | $501.19 | $707.95 |
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 $2,570.40 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,570.40 | $3,162.28 | $5,495.41 |
ConnectiCare Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,981.07 | Professional | None | $3,311.31 | $3,311.31 | $3,981.07 |
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 $2,290.87 Median $3,467.37 Typical High $7,413.10 | Professional | None | $2,290.87 | $3,467.37 | $7,413.10 |
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 $1,174.90 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,174.90 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $467.74 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,737.80 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $346.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $234.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,621.81 | $2,691.53 | $2,691.53 |
Where Connecticut sits
The same service costs 6.6 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
$3,631
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.