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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | None | $776.25 | $1,230.27 | $1,230.27 |
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 $741.31 Median $1,202.26 Typical High $1,778.28 | Professional | None | $741.31 | $1,202.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $741.31 Typical High $1,122.02 | Professional | 62 · Two surgeons | $457.09 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $117.49 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $165.96 Typical High $245.47 | Professional | AS · PA/NP assist | $102.33 | $165.96 | $245.47 |
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 $1,047.13 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,288.25 | $1,737.80 |
ConnectiCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
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 $831.76 Median $1,148.15 Typical High $2,398.83 | Professional | None | $831.76 | $1,148.15 | $2,398.83 |
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 $380.19 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $380.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $575.44 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $77.62 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $537.03 | $851.14 | $851.14 |
Where Connecticut sits
The same service costs 6.2 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
$1,230
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.