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 $1,479.11 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,479.11 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,288.25 | $2,187.76 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,380.38 Typical High $1,949.84 | Professional | 62 · Two surgeons | $812.83 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $346.74 Typical High $489.78 | Professional | 80 · Assistant surgeon | $204.17 | $346.74 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $302.00 Typical High $436.52 | Professional | AS · PA/NP assist | $177.83 | $302.00 | $436.52 |
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 $1,548.82 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,137.96 | $3,311.31 |
ConnectiCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,380.38 Median $2,238.72 Typical High $4,466.84 | Professional | None | $1,380.38 | $2,238.72 | $4,466.84 |
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 $741.31 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $741.31 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,122.02 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $223.87 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $147.91 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,513.56 | $1,513.56 |
Where Connecticut sits
The same service costs 4.9 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
$2,188
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.