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 $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | None | $776.25 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,174.90 Typical High $1,621.81 | Professional | None | $724.44 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $691.83 Typical High $1,023.29 | Professional | 62 · Two surgeons | $446.68 | $691.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $177.83 Typical High $263.03 | Professional | 80 · Assistant surgeon | $112.20 | $177.83 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $151.36 Typical High $229.09 | Professional | AS · PA/NP assist | $100.00 | $151.36 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,606.93 Typical High $8,317.64 | Facility | None | $851.14 | $6,606.93 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,230.27 | $1,659.59 |
ConnectiCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,348.96 | $1,348.96 | $1,380.38 |
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 $2,290.87 | Professional | None | $794.33 | $1,096.48 | $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 $389.05 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $389.05 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $575.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $537.03 | $758.58 | $758.58 |
Where Connecticut sits
The same service costs 6.8 times more in Oklahoma 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· 20th of 51
$1,202
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.