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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $933.25 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $11,748.98 Typical High $13,803.84 | Facility | None | $3,981.07 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,862.09 | Professional | None | $776.25 | $1,258.93 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $794.33 Typical High $1,174.90 | Professional | 62 · Two surgeons | $489.78 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $199.53 Typical High $302.00 | Professional | 80 · Assistant surgeon | $125.89 | $199.53 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $173.78 Typical High $263.03 | Professional | AS · PA/NP assist | $109.65 | $173.78 | $263.03 |
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 $1,071.52 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,288.25 | $2,089.30 |
ConnectiCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,318.26 | $1,479.11 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $2,630.27 | Professional | None | $794.33 | $1,096.48 | $2,630.27 |
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 $467.74 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $467.74 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $186.21 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $141.25 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 6.2 times more in Oklahoma 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· 14th of 51
$1,479
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.