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 $891.25 Median $1,584.89 Typical High $1,584.89 | Professional | None | $891.25 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,995.26 | Professional | None | $758.58 | $1,288.25 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $812.83 Typical High $1,258.93 | Professional | 62 · Two surgeons | $478.63 | $812.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $208.93 Typical High $323.59 | Professional | 80 · Assistant surgeon | $123.03 | $208.93 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $181.97 Typical High $281.84 | Professional | AS · PA/NP assist | $107.15 | $181.97 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $2,454.71 | Facility | None | $660.69 | $1,380.38 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,380.38 | $2,041.74 |
ConnectiCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,445.44 | $1,445.44 | $1,548.82 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,019.95 | Professional | None | $891.25 | $1,380.38 | $3,019.95 |
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 $446.68 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $446.68 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $177.83 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $676.08 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $134.90 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $89.13 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $630.96 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 4.4 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· 9th of 51
$1,479
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.