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 $2,398.83 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,398.83 | $3,630.78 | $3,630.78 |
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 $2,398.83 Median $4,786.30 Typical High $6,456.54 | Professional | None | $2,398.83 | $4,786.30 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $3,019.95 Typical High $3,981.07 | Professional | 62 · Two surgeons | $1,513.56 | $3,019.95 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $758.58 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $380.19 | $758.58 | $1,023.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $660.69 Typical High $891.25 | Professional | AS · PA/NP assist | $338.84 | $660.69 | $891.25 |
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 $2,951.21 Median $3,388.44 Typical High $5,370.32 | Professional | None | $2,951.21 | $3,388.44 | $5,370.32 |
ConnectiCare Setting Professional Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $3,890.45 | Professional | None | $2,951.21 | $3,630.78 | $3,890.45 |
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 $2,187.76 Median $3,715.35 Typical High $8,511.38 | Professional | None | $2,187.76 | $3,715.35 | $8,511.38 |
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 $1,202.26 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,202.26 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $478.63 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,819.70 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $363.08 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $239.88 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,511.89 | $2,511.89 |
Where Connecticut sits
The same service costs 21.4 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· 11th of 51
$4,074
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.