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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $17,378.01 Typical High $28,183.83 | Facility | None | $3,715.35 | $17,378.01 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,148.15 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,548.82 Typical High $2,089.30 | Professional | 62 · Two surgeons | $724.44 | $1,548.82 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $398.11 Typical High $524.81 | Professional | 80 · Assistant surgeon | $181.97 | $398.11 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $346.74 Typical High $467.74 | Professional | AS · PA/NP assist | $162.18 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,471.29 Typical High $13,182.57 | Facility | None | $851.14 | $10,471.29 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,513.56 | $1,698.24 | $2,754.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,862.09 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $18,197.01 | Facility | None | $1,348.96 | $9,549.93 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $4,365.16 | Professional | None | $1,122.02 | $1,949.84 | $4,365.16 |
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 $616.60 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $616.60 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $245.47 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $912.01 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $186.21 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $123.03 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $851.14 | $1,288.25 | $1,288.25 |
Where Connecticut sits
The same service costs 25.7 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· 13th of 51
$2,089
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.