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 $812.83 Median $1,288.25 Typical High $1,288.25 | Professional | None | $812.83 | $1,288.25 | $1,288.25 |
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 $676.08 Median $1,096.48 Typical High $1,621.81 | Professional | None | $676.08 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $691.83 Typical High $1,023.29 | Professional | 62 · Two surgeons | $426.58 | $691.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $173.78 Typical High $263.03 | Professional | 80 · Assistant surgeon | $109.65 | $173.78 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $151.36 Typical High $229.09 | Professional | AS · PA/NP assist | $95.50 | $151.36 | $229.09 |
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 $933.25 Median $1,122.02 Typical High $1,819.70 | Professional | None | $933.25 | $1,122.02 | $1,819.70 |
ConnectiCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,148.15 | $1,288.25 |
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 $691.83 Median $954.99 Typical High $2,290.87 | Professional | None | $691.83 | $954.99 | $2,290.87 |
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 $407.38 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $407.38 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $162.18 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $602.56 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $120.23 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $81.28 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $562.34 | $891.25 | $891.25 |
Where Connecticut sits
The same service costs 5.4 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· 13th of 51
$1,288
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.