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 $1,479.11 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,479.11 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $10,964.78 Typical High $13,489.63 | Facility | None | $2,884.03 | $10,964.78 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $3,019.95 Typical High $4,073.80 | Professional | None | $1,479.11 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,905.46 Typical High $2,570.40 | Professional | 62 · Two surgeons | $933.25 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $489.78 Typical High $660.69 | Professional | 80 · Assistant surgeon | $234.42 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $204.17 | $426.58 | $575.44 |
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 $1,819.70 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,819.70 | $1,949.84 | $3,311.31 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,187.76 | $2,511.89 |
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 $1,380.38 Median $2,290.87 Typical High $5,370.32 | Professional | None | $1,380.38 | $2,290.87 | $5,370.32 |
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 $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $741.31 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $295.12 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,122.02 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $223.87 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $147.91 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,479.11 | $1,479.11 |
Where Connecticut sits
The same service costs 5.1 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· 11th of 51
$2,570
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.