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 $5,248.07 Median $9,549.93 Typical High $15,135.61 | Facility | None | $5,248.07 | $9,549.93 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | None | $758.58 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $13,489.63 Typical High $19,952.62 | Facility | None | $7,585.78 | $13,489.63 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,548.82 Typical High $2,041.74 | Professional | None | $707.95 | $1,548.82 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $977.24 Typical High $1,288.25 | Professional | 62 · Two surgeons | $446.68 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $114.82 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $100.00 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $27,542.29 | Facility | None | $512.86 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,698.24 | Professional | None | $954.99 | $1,096.48 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,288.25 | Professional | None | $933.25 | $1,174.90 | $1,288.25 |
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 $691.83 Median $1,202.26 Typical High $2,691.53 | Professional | None | $691.83 | $1,202.26 | $2,691.53 |
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 $380.19 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $380.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $575.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $114.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $75.86 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $537.03 | $812.83 | $812.83 |
Where Connecticut sits
The same service costs 5.9 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· 12th of 51
$1,318
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.