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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | None | $281.84 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $436.52 Typical High $588.84 | Professional | None | $251.19 | $436.52 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $602.56 Typical High $891.25 | Professional | 50 · Both sides | $371.54 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $158.49 Median $251.19 Typical High $371.54 | Professional | 62 · Two surgeons | $158.49 | $251.19 | $371.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $64.57 Typical High $93.33 | Professional | 80 · Assistant surgeon | $39.81 | $64.57 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $56.23 Typical High $83.18 | Professional | AS · PA/NP assist | $34.67 | $56.23 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $4,466.84 | Facility | None | $851.14 | $3,630.78 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $630.96 | Professional | None | $389.05 | $457.09 | $630.96 |
ConnectiCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | None | $501.19 | $501.19 | $512.86 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $851.14 | Professional | None | $295.12 | $416.87 | $851.14 |
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 $138.04 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $54.95 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $204.17 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $27.54 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $190.55 | $281.84 | $281.84 |
Where Connecticut sits
The same service costs 6.0 times more in Oklahoma 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· 28th of 51
$447
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.