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 $2,137.96 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,137.96 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $12,022.64 Typical High $14,125.38 | Facility | None | $2,884.03 | $12,022.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $2,041.74 Typical High $4,677.35 | Professional | None | $1,258.93 | $2,041.74 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,288.25 Typical High $2,951.21 | Professional | 62 · Two surgeons | $794.33 | $1,288.25 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $331.13 Typical High $758.58 | Professional | 80 · Assistant surgeon | $199.53 | $331.13 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $288.40 Typical High $660.69 | Professional | AS · PA/NP assist | $173.78 | $288.40 | $660.69 |
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 $1,737.80 Median $3,388.44 Typical High $6,309.57 | Professional | None | $1,737.80 | $3,388.44 | $6,309.57 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,862.09 | $3,388.44 |
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 $2,089.30 Typical High $3,890.45 | Professional | None | $891.25 | $2,089.30 | $3,890.45 |
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 $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,071.52 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,621.81 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $323.59 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $213.80 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,238.72 | $2,238.72 |
Where Connecticut sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 41st of 51
$2,042
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.