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 $1,000.00 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,479.11 | $1,479.11 |
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 $977.24 Median $2,041.74 Typical High $2,754.23 | Professional | None | $977.24 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $1,288.25 Typical High $1,737.80 | Professional | 62 · Two surgeons | $616.60 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $331.13 Typical High $436.52 | Professional | 80 · Assistant surgeon | $158.49 | $331.13 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $138.04 | $288.40 | $389.05 |
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 $1,202.26 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,380.38 | $2,238.72 |
ConnectiCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,548.82 | $1,737.80 |
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 $912.01 Median $1,548.82 Typical High $3,548.13 | Professional | None | $912.01 | $1,548.82 | $3,548.13 |
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 $489.78 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $489.78 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $199.53 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $100.00 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $691.83 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 4.9 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
$1,738
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.