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 $1,202.26 Typical High $1,202.26 | Professional | None | $812.83 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $14,454.40 Typical High $19,498.45 | Facility | None | $5,754.40 | $14,454.40 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $1,819.70 | Professional | None | $776.25 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $758.58 Typical High $1,148.15 | Professional | 62 · Two surgeons | $489.78 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $194.98 Typical High $295.12 | Professional | 80 · Assistant surgeon | $123.03 | $194.98 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $169.82 Typical High $257.04 | Professional | AS · PA/NP assist | $109.65 | $169.82 | $257.04 |
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 $1,122.02 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,348.96 | $1,819.70 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $870.96 Median $1,202.26 Typical High $2,511.89 | Professional | None | $870.96 | $1,202.26 | $2,511.89 |
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 $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $407.38 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $162.18 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $602.56 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $81.28 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $562.34 | $851.14 | $851.14 |
Where Connecticut sits
The same service costs 6.3 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· 14th of 51
$1,259
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.