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 $1,778.28 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,754.23 | $2,754.23 |
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 $1,659.59 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,659.59 | $2,290.87 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,445.44 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,023.29 | $1,445.44 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $363.08 Typical High $616.60 | Professional | 80 · Assistant surgeon | $263.03 | $363.08 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $316.23 Typical High $537.03 | Professional | AS · PA/NP assist | $229.09 | $316.23 | $537.03 |
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 $2,344.23 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,344.23 | $2,754.23 | $4,466.84 |
ConnectiCare Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,090.30 | Professional | None | $2,884.03 | $2,884.03 | $3,090.30 |
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 $1,659.59 Median $2,187.76 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,187.76 | $4,570.88 |
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 $891.25 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $891.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $354.81 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,348.96 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $177.83 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,905.46 | $1,905.46 |
Where Connecticut sits
The same service costs 5.9 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· 26th of 51
$2,344
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.