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 $1,659.59 Median $2,884.03 Typical High $2,884.03 | Professional | None | $1,659.59 | $2,884.03 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $14,791.08 Typical High $19,952.62 | Facility | None | $5,888.44 | $14,791.08 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,344.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,479.11 Typical High $2,089.30 | Professional | 62 · Two surgeons | $891.25 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $380.19 Typical High $537.03 | Professional | 80 · Assistant surgeon | $223.87 | $380.19 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $331.13 Typical High $467.74 | Professional | AS · PA/NP assist | $194.98 | $331.13 | $467.74 |
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 $1,737.80 Median $2,238.72 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,238.72 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
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 $1,380.38 Median $1,949.84 Typical High $4,786.30 | Professional | None | $1,380.38 | $1,949.84 | $4,786.30 |
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 $831.76 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $831.76 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $331.13 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,258.93 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $251.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $165.96 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,174.90 | $2,041.74 | $2,041.74 |
Where Connecticut sits
The same service costs 5.6 times more in Alaska than in Utah. 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
$2,344
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.