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 $5,248.07 Median $9,549.93 Typical High $15,488.17 | Facility | None | $5,248.07 | $9,549.93 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $14,791.08 Typical High $18,620.87 | Facility | None | $7,762.47 | $14,791.08 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,862.09 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,174.90 Typical High $1,862.09 | Professional | 62 · Two surgeons | $724.44 | $1,174.90 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $295.12 Typical High $478.63 | Professional | 80 · Assistant surgeon | $181.97 | $295.12 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $257.04 Typical High $416.87 | Professional | AS · PA/NP assist | $162.18 | $257.04 | $416.87 |
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 $1,659.59 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,041.74 | $2,691.53 |
ConnectiCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,187.76 | $2,238.72 | $2,238.72 |
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 $1,318.26 Median $1,819.70 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,819.70 | $3,801.89 |
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 $616.60 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $616.60 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $245.47 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $912.01 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $181.97 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $123.03 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $851.14 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 7.1 times more in Alaska 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· 13th of 51
$1,905
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.