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 $1,230.27 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,905.46 | $1,905.46 |
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 $1,122.02 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,949.84 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,230.27 Typical High $1,737.80 | Professional | 62 · Two surgeons | $707.95 | $1,230.27 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $316.23 Typical High $436.52 | Professional | 80 · Assistant surgeon | $177.83 | $316.23 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $275.42 Typical High $380.19 | Professional | AS · PA/NP assist | $154.88 | $275.42 | $380.19 |
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 $1,348.96 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,862.09 | $2,951.21 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
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 $1,202.26 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,202.26 | $1,949.84 | $3,890.45 |
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 $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $251.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $1,318.26 |
Where Connecticut sits
The same service costs 5.6 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· 14th of 51
$1,950
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.