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 $549.54 Median $794.33 Typical High $794.33 | Professional | None | $549.54 | $794.33 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $1,548.82 | Professional | None | $562.34 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $724.44 Typical High $977.24 | Professional | 62 · Two surgeons | $346.74 | $724.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $186.21 Typical High $245.47 | Professional | 80 · Assistant surgeon | $87.10 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $162.18 Typical High $218.78 | Professional | AS · PA/NP assist | $75.86 | $162.18 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $1,698.24 | Facility | None | $549.54 | $1,380.38 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,230.27 | Professional | None | $691.83 | $812.83 | $1,230.27 |
ConnectiCare Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $977.24 | Professional | None | $707.95 | $851.14 | $977.24 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $501.19 Median $891.25 Typical High $1,949.84 | Professional | None | $501.19 | $891.25 | $1,949.84 |
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 $275.42 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $275.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $416.87 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $83.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $389.05 | $549.54 | $549.54 |
Where Connecticut sits
The same service costs 5.5 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· 12th of 51
$977
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.