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 $3,388.44 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,388.44 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,890.45 Median $6,918.31 Typical High $9,332.54 | Professional | None | $3,890.45 | $6,918.31 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,454.71 Median $4,365.16 Typical High $5,888.44 | Professional | 62 · Two surgeons | $2,454.71 | $4,365.16 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $616.60 Median $1,122.02 Typical High $1,513.56 | Professional | 80 · Assistant surgeon | $616.60 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $537.03 Median $977.24 Typical High $1,318.26 | Professional | AS · PA/NP assist | $537.03 | $977.24 | $1,318.26 |
ConnectiCare Setting Professional Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $5,888.44 | Professional | None | $4,265.80 | $5,248.07 | $5,888.44 |
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 $3,162.28 Median $5,623.41 Typical High $12,302.69 | Professional | None | $3,162.28 | $5,623.41 | $12,302.69 |
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 $1,737.80 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,737.80 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $691.83 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $2,630.27 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $524.81 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $346.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,454.71 | $3,467.37 | $3,467.37 |
Where Connecticut sits
The same service costs 27.5 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· 8th of 51
$6,761
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.