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 $1,698.24 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,630.27 | $2,630.27 |
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 $1,778.28 Median $3,548.13 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,548.13 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $2,238.72 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,096.48 | $2,238.72 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $562.34 Typical High $758.58 | Professional | 80 · Assistant surgeon | $281.84 | $562.34 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $489.78 Typical High $660.69 | Professional | AS · PA/NP assist | $245.47 | $489.78 | $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 $2,187.76 Median $2,454.71 Typical High $3,981.07 | Professional | None | $2,187.76 | $2,454.71 | $3,981.07 |
ConnectiCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,691.53 | $2,951.21 |
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 $1,621.81 Median $2,818.38 Typical High $6,309.57 | Professional | None | $1,621.81 | $2,818.38 | $6,309.57 |
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 $851.14 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $851.14 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $338.84 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,288.25 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $257.04 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $169.82 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,862.09 | $1,862.09 |
Where Connecticut sits
The same service costs 5.4 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
$3,020
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.