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 $2,511.89 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,511.89 | $3,467.37 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $12,589.25 Typical High $16,218.10 | Facility | None | $3,630.78 | $12,589.25 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $3,890.45 Typical High $5,248.07 | Professional | None | $2,238.72 | $3,890.45 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $2,454.71 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,318.26 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $616.60 Typical High $851.14 | Professional | 80 · Assistant surgeon | $338.84 | $616.60 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $537.03 Typical High $741.31 | Professional | AS · PA/NP assist | $295.12 | $537.03 | $741.31 |
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 $2,238.72 Median $2,884.03 Typical High $5,888.44 | Professional | None | $2,238.72 | $2,884.03 | $5,888.44 |
ConnectiCare Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $4,265.80 | Professional | None | $2,570.40 | $2,570.40 | $4,265.80 |
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 $2,187.76 Median $3,715.35 Typical High $7,943.28 | Professional | None | $2,187.76 | $3,715.35 | $7,943.28 |
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 $1,258.93 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,258.93 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $512.86 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,905.46 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $380.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $251.19 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,454.71 | $2,454.71 |
Where Connecticut sits
The same service costs 6.2 times more in Alaska than in Delaware. 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
$3,890
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.