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 $6,760.83 Typical High $12,302.69 | Facility | None | $4,365.16 | $6,760.83 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,318.26 | $2,089.30 | $2,089.30 |
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 $1,380.38 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,380.38 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,348.96 Typical High $2,041.74 | Professional | 62 · Two surgeons | $851.14 | $1,348.96 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $323.59 Typical High $512.86 | Professional | 80 · Assistant surgeon | $218.78 | $323.59 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $281.84 Typical High $436.52 | Professional | AS · PA/NP assist | $190.55 | $281.84 | $436.52 |
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 $1,905.46 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,137.96 | $3,090.30 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,344.23 | $2,630.27 |
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 $1,445.44 Median $1,995.26 Typical High $4,265.80 | Professional | None | $1,445.44 | $1,995.26 | $4,265.80 |
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 $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $660.69 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $263.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $977.24 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $131.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $912.01 | $1,479.11 | $1,479.11 |
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· 14th of 51
$2,138
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.