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 $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $12,022.64 Typical High $14,125.38 | Facility | None | $4,073.80 | $12,022.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,023.29 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,318.26 Typical High $1,778.28 | Professional | 62 · Two surgeons | $645.65 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $338.84 Typical High $446.68 | Professional | 80 · Assistant surgeon | $165.96 | $338.84 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $295.12 Typical High $398.11 | Professional | AS · PA/NP assist | $144.54 | $295.12 | $398.11 |
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 $1,288.25 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,445.44 | $2,344.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,584.89 | $1,778.28 |
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 $954.99 Median $1,659.59 Typical High $3,715.35 | Professional | None | $954.99 | $1,659.59 | $3,715.35 |
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 $512.86 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $512.86 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $208.93 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $104.71 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 24.5 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· 11th of 51
$1,778
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.