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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | None | $616.60 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $1,513.56 | Professional | None | $588.84 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $741.31 Typical High $954.99 | Professional | 62 · Two surgeons | $371.54 | $741.31 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $186.21 Typical High $245.47 | Professional | 80 · Assistant surgeon | $95.50 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $162.18 Typical High $213.80 | Professional | AS · PA/NP assist | $83.18 | $162.18 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,162.28 Typical High $4,073.80 | Facility | None | $1,000.00 | $3,162.28 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,348.96 | Professional | None | $741.31 | $1,000.00 | $1,348.96 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,071.52 | Professional | None | $660.69 | $851.14 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $2,137.96 | Professional | None | $537.03 | $954.99 | $2,137.96 |
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 $309.03 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $457.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $61.66 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 6.5 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· 11th of 51
$1,096
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.