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 $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $776.25 | $1,412.54 | $1,412.54 |
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 $724.44 Median $1,174.90 Typical High $1,737.80 | Professional | None | $724.44 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $741.31 Typical High $1,096.48 | Professional | 62 · Two surgeons | $457.09 | $741.31 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $186.21 Typical High $281.84 | Professional | 80 · Assistant surgeon | $117.49 | $186.21 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $162.18 Typical High $245.47 | Professional | AS · PA/NP assist | $102.33 | $162.18 | $245.47 |
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 $977.24 Median $1,174.90 Typical High $1,949.84 | Professional | None | $977.24 | $1,174.90 | $1,949.84 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,230.27 | $1,380.38 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $2,454.71 | Professional | None | $741.31 | $1,023.29 | $2,454.71 |
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 $436.52 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $173.78 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $645.65 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $128.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $87.10 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $602.56 | $977.24 | $977.24 |
Where Connecticut sits
The same service costs 5.9 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· 12th of 51
$1,380
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.