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 $1,230.27 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $13,489.63 Typical High $23,442.29 | Facility | None | $2,884.03 | $13,489.63 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,258.93 | $2,511.89 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,584.89 Typical High $2,137.96 | Professional | 62 · Two surgeons | $794.33 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $407.38 Typical High $537.03 | Professional | 80 · Assistant surgeon | $199.53 | $407.38 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $354.81 Typical High $467.74 | Professional | AS · PA/NP assist | $177.83 | $354.81 | $467.74 |
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 $1,548.82 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,737.80 | $2,818.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,905.46 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $4,466.84 | Professional | None | $1,148.15 | $1,995.26 | $4,466.84 |
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 $616.60 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $616.60 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $123.03 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $1,318.26 |
Where Connecticut sits
The same service costs 26.3 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
$2,138
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.