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 $1,737.80 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,737.80 | $2,630.27 | $2,630.27 |
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 $1,778.28 Median $3,467.37 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,467.37 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $2,187.76 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,096.48 | $2,187.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $549.54 Typical High $741.31 | Professional | 80 · Assistant surgeon | $275.42 | $549.54 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $489.78 Typical High $645.65 | Professional | AS · PA/NP assist | $245.47 | $489.78 | $645.65 |
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 $2,137.96 Median $2,454.71 Typical High $3,890.45 | Professional | None | $2,137.96 | $2,454.71 | $3,890.45 |
ConnectiCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,630.27 | $2,951.21 |
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 $1,621.81 Median $2,691.53 Typical High $6,309.57 | Professional | None | $1,621.81 | $2,691.53 | $6,309.57 |
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 $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $870.96 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $346.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,318.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $263.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $173.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,862.09 | $1,862.09 |
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
$2,951
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.