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 $1,071.52 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $2,344.23 | Professional | None | $933.25 | $1,584.89 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $1,000.00 Typical High $1,513.56 | Professional | 62 · Two surgeons | $588.84 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $251.19 Typical High $380.19 | Professional | 80 · Assistant surgeon | $147.91 | $251.19 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $223.87 Typical High $331.13 | Professional | AS · PA/NP assist | $131.83 | $223.87 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,584.89 | $2,398.83 |
ConnectiCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,698.24 | $1,698.24 | $1,778.28 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,659.59 | $3,311.31 |
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 $537.03 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $537.03 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $218.78 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $812.83 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $162.18 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $107.15 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $758.58 | $1,288.25 | $1,288.25 |
Where Connecticut sits
The same service costs 4.6 times more in Wisconsin 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
$1,862
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.