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 $1,737.80 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,737.80 | $1,737.80 |
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 $1,148.15 Median $2,344.23 Typical High $3,090.30 | Professional | None | $1,148.15 | $2,344.23 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,479.11 Typical High $1,949.84 | Professional | 62 · Two surgeons | $707.95 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $371.54 Typical High $501.19 | Professional | 80 · Assistant surgeon | $181.97 | $371.54 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $323.59 Typical High $436.52 | Professional | AS · PA/NP assist | $158.49 | $323.59 | $436.52 |
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 $1,621.81 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,621.81 | $2,570.40 |
ConnectiCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,778.28 | $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 $575.44 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $575.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $229.09 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $870.96 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $173.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $114.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $812.83 | $1,202.26 | $1,202.26 |
Where Connecticut sits
The same service costs 5.4 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
$1,995
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.