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 $2,398.83 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,398.83 | $3,801.89 | $3,801.89 |
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 $1,949.84 Median $3,235.94 Typical High $4,677.35 | Professional | None | $1,949.84 | $3,235.94 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,995.26 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,230.27 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $501.19 Typical High $758.58 | Professional | 80 · Assistant surgeon | $316.23 | $501.19 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $446.68 Typical High $660.69 | Professional | AS · PA/NP assist | $275.42 | $446.68 | $660.69 |
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 $2,691.53 Median $3,311.31 Typical High $5,248.07 | Professional | None | $2,691.53 | $3,311.31 | $5,248.07 |
ConnectiCare Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,715.35 | Professional | None | $3,388.44 | $3,388.44 | $3,715.35 |
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 $1,995.26 Median $2,818.38 Typical High $6,760.83 | Professional | None | $1,995.26 | $2,818.38 | $6,760.83 |
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 $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,202.26 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,778.28 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $363.08 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $239.88 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,630.27 | $2,630.27 |
Where Connecticut sits
The same service costs 6.2 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· 13th of 51
$3,388
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.