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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | None | $741.31 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $15,848.93 Typical High $18,620.87 | Facility | None | $1,122.02 | $15,848.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,513.56 Typical High $2,041.74 | Professional | None | $707.95 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $436.52 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $112.20 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $97.72 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,698.24 | Professional | None | $933.25 | $1,096.48 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,288.25 | Professional | None | $933.25 | $1,174.90 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $2,691.53 | Professional | None | $691.83 | $1,202.26 | $2,691.53 |
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 $371.54 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $371.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $151.36 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $562.34 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $112.20 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $74.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $524.81 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 25.1 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
$1,288
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.