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 $4,570.88 Median $8,511.38 Typical High $13,489.63 | Facility | None | $4,570.88 | $8,511.38 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $14,125.38 Typical High $26,915.35 | Facility | None | $8,128.31 | $14,125.38 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,230.27 Typical High $1,819.70 | Professional | 62 · Two surgeons | $758.58 | $1,230.27 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $194.98 | $309.03 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $269.15 Typical High $407.38 | Professional | AS · PA/NP assist | $169.82 | $269.15 | $407.38 |
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 $1,737.80 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,137.96 | $2,884.03 |
ConnectiCare Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,905.46 | $3,981.07 |
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 $645.65 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $645.65 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $257.04 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $977.24 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $194.98 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $912.01 | $1,318.26 | $1,318.26 |
Where Connecticut sits
The same service costs 6.9 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· 20th of 51
$2,042
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.