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 $1,023.29 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $15,135.61 Typical High $23,442.29 | Facility | None | $6,918.31 | $15,135.61 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,000.00 | $2,041.74 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $616.60 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $158.49 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $281.84 Typical High $380.19 | Professional | AS · PA/NP assist | $138.04 | $281.84 | $380.19 |
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 $1,258.93 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,479.11 | $2,187.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,548.82 | $1,698.24 |
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 $891.25 Median $1,584.89 Typical High $3,467.37 | Professional | None | $891.25 | $1,584.89 | $3,467.37 |
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 $512.86 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $512.86 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $204.17 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $758.58 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $154.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $102.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $707.95 | $1,122.02 | $1,122.02 |
Where Connecticut sits
The same service costs 24.5 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
$1,698
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.