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 $4,466.84 Median $7,079.46 Typical High $7,079.46 | Professional | None | $4,466.84 | $7,079.46 | $7,079.46 |
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 $4,365.16 Median $8,709.64 Typical High $11,748.98 | Professional | None | $4,365.16 | $8,709.64 | $11,748.98 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,691.53 Median $5,495.41 Typical High $7,413.10 | Professional | 62 · Two surgeons | $2,691.53 | $5,495.41 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $1,380.38 Typical High $1,862.09 | Professional | 80 · Assistant surgeon | $691.83 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $1,230.27 Typical High $1,621.81 | Professional | AS · PA/NP assist | $602.56 | $1,230.27 | $1,621.81 |
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 $5,248.07 Typical High $9,772.37 | Professional | None | $2,818.38 | $5,248.07 | $9,772.37 |
ConnectiCare Setting Professional Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $7,413.10 | Professional | None | $5,011.87 | $6,606.93 | $7,413.10 |
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 $3,981.07 Median $5,754.40 Typical High $15,488.17 | Professional | None | $3,981.07 | $5,754.40 | $15,488.17 |
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 $2,238.72 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $2,238.72 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $912.01 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $3,388.44 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $676.08 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $707.95 Typical High $707.95 | Professional | 56 · Pre-op care only | $457.09 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $3,162.28 | $4,897.79 | $4,897.79 |
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
$7,413
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.