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 $3,630.78 Median $5,623.41 Typical High $5,623.41 | Professional | None | $3,630.78 | $5,623.41 | $5,623.41 |
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 $3,467.37 Median $6,918.31 Typical High $9,332.54 | Professional | None | $3,467.37 | $6,918.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $4,365.16 Typical High $5,888.44 | Professional | 62 · Two surgeons | $2,187.76 | $4,365.16 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $562.34 Median $1,122.02 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $562.34 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $977.24 Typical High $1,318.26 | Professional | AS · PA/NP assist | $489.78 | $977.24 | $1,318.26 |
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 $2,818.38 Median $4,168.69 Typical High $7,762.47 | Professional | None | $2,818.38 | $4,168.69 | $7,762.47 |
ConnectiCare Setting Professional Modifier None Typical Low $4,265.80 Median $5,623.41 Typical High $6,025.60 | Professional | None | $4,265.80 | $5,623.41 | $6,025.60 |
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 $3,235.94 Median $4,786.30 Typical High $12,589.25 | Professional | None | $3,235.94 | $4,786.30 | $12,589.25 |
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 $1,819.70 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,819.70 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $724.44 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,754.23 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $549.54 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $363.08 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,570.40 | $3,981.07 | $3,981.07 |
Where Connecticut sits
The same service costs 21.9 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
$5,888
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.