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 $4,073.80 Median $6,309.57 Typical High $6,309.57 | Professional | None | $4,073.80 | $6,309.57 | $6,309.57 |
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 $4,168.69 Median $8,317.64 Typical High $11,220.18 | Professional | None | $4,168.69 | $8,317.64 | $11,220.18 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,630.27 Median $5,248.07 Typical High $7,079.46 | Professional | 62 · Two surgeons | $2,630.27 | $5,248.07 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $660.69 Median $1,318.26 Typical High $1,778.28 | Professional | 80 · Assistant surgeon | $660.69 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $1,174.90 Typical High $1,548.82 | Professional | AS · PA/NP assist | $575.44 | $1,174.90 | $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 $5,623.41 Typical High $9,332.54 | Professional | None | $5,011.87 | $5,623.41 | $9,332.54 |
ConnectiCare Setting Professional Modifier None Typical Low $4,897.79 Median $6,025.60 Typical High $7,079.46 | Professional | None | $4,897.79 | $6,025.60 | $7,079.46 |
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 $6,760.83 Typical High $14,791.08 | Professional | None | $3,801.89 | $6,760.83 | $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 $2,089.30 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $2,089.30 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $831.76 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $3,090.30 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $630.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $416.87 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,884.03 | $4,466.84 | $4,466.84 |
Where Connecticut sits
The same service costs 20.9 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
$7,079
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.