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 $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | None | $724.44 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,621.81 | Professional | None | $676.08 | $954.99 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $602.56 Typical High $1,000.00 | Professional | 62 · Two surgeons | $426.58 | $602.56 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $151.36 Typical High $257.04 | Professional | 80 · Assistant surgeon | $109.65 | $151.36 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $131.83 Typical High $223.87 | Professional | AS · PA/NP assist | $95.50 | $131.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $6,918.31 | Facility | None | $851.14 | $5,623.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,819.70 | Professional | None | $977.24 | $1,122.02 | $1,819.70 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,862.09 | Professional | None | $676.08 | $954.99 | $1,862.09 |
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 $363.08 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $363.08 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $147.91 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $549.54 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $109.65 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $72.44 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $512.86 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 8.7 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· 29th of 51
$1,023
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.