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 $3,890.45 Median $5,888.44 Typical High $5,888.44 | Professional | None | $3,890.45 | $5,888.44 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $10,964.78 Typical High $13,489.63 | Facility | None | $3,162.28 | $10,964.78 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,073.80 Median $8,128.31 Typical High $10,964.78 | Professional | None | $4,073.80 | $8,128.31 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,511.89 Median $5,128.61 Typical High $6,918.31 | Professional | 62 · Two surgeons | $2,511.89 | $5,128.61 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $1,318.26 Typical High $1,737.80 | Professional | 80 · Assistant surgeon | $645.65 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $1,148.15 Typical High $1,548.82 | Professional | AS · PA/NP assist | $562.34 | $1,148.15 | $1,548.82 |
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 $5,011.87 Median $5,370.32 Typical High $9,120.11 | Professional | None | $5,011.87 | $5,370.32 | $9,120.11 |
ConnectiCare Setting Professional Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $6,918.31 | Professional | None | $4,677.35 | $5,888.44 | $6,918.31 |
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 $3,801.89 Median $6,309.57 Typical High $14,791.08 | Professional | None | $3,801.89 | $6,309.57 | $14,791.08 |
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 $1,995.26 Median $2,951.21 Typical High $2,951.21 | Professional | 52 · Reduced service | $1,995.26 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $794.33 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,951.21 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $588.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $398.11 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,754.23 | $4,073.80 | $4,073.80 |
Where Connecticut sits
The same service costs 21.9 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
$6,918
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.