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 $2,290.87 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,290.87 | $3,467.37 | $3,467.37 |
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 $2,238.72 Median $4,466.84 Typical High $5,888.44 | Professional | None | $2,238.72 | $4,466.84 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $2,818.38 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,412.54 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $707.95 Typical High $954.99 | Professional | 80 · Assistant surgeon | $354.81 | $707.95 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $616.60 Typical High $831.76 | Professional | AS · PA/NP assist | $309.03 | $616.60 | $831.76 |
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 $2,754.23 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,754.23 | $3,162.28 | $4,897.79 |
ConnectiCare Setting Professional Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $3,801.89 | Professional | None | $2,511.89 | $3,388.44 | $3,801.89 |
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 $2,041.74 Median $3,630.78 Typical High $8,128.31 | Professional | None | $2,041.74 | $3,630.78 | $8,128.31 |
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 $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,148.15 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $457.09 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,698.24 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $338.84 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $229.09 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,584.89 | $2,398.83 | $2,398.83 |
Where Connecticut sits
The same service costs 22.4 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
$3,802
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.