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 $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,238.72 | $2,238.72 |
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 $1,513.56 Median $2,951.21 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,951.21 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,862.09 Typical High $2,511.89 | Professional | 62 · Two surgeons | $912.01 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $478.63 Typical High $630.96 | Professional | 80 · Assistant surgeon | $234.42 | $478.63 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $416.87 Typical High $562.34 | Professional | AS · PA/NP assist | $204.17 | $416.87 | $562.34 |
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 $1,819.70 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,089.30 | $3,311.31 |
ConnectiCare Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $2,454.71 | Professional | None | $1,819.70 | $2,290.87 | $2,454.71 |
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 $1,348.96 Median $2,398.83 Typical High $5,370.32 | Professional | None | $1,348.96 | $2,398.83 | $5,370.32 |
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 $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $295.12 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,122.02 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,584.89 | $1,584.89 |
Where Connecticut sits
The same service costs 20.9 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
$2,512
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.