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 $1,122.02 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,698.24 | $1,698.24 |
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 $1,122.02 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,122.02 | $2,290.87 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $1,445.44 Typical High $1,949.84 | Professional | 62 · Two surgeons | $691.83 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $363.08 Typical High $489.78 | Professional | 80 · Assistant surgeon | $177.83 | $363.08 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $323.59 Typical High $426.58 | Professional | AS · PA/NP assist | $154.88 | $323.59 | $426.58 |
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 $1,380.38 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,584.89 | $2,511.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
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 $1,047.13 Median $1,737.80 Typical High $4,073.80 | Professional | None | $1,047.13 | $1,737.80 | $4,073.80 |
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 $562.34 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $562.34 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $229.09 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $851.14 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $169.82 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $112.20 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $794.33 | $1,202.26 | $1,202.26 |
Where Connecticut sits
The same service costs 5.6 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
$1,950
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.