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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $524.81 | Professional | None | $354.81 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $812.83 | Professional | None | $354.81 | $562.34 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $338.84 Typical High $512.86 | Professional | 62 · Two surgeons | $218.78 | $338.84 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $85.11 Typical High $131.83 | Professional | 80 · Assistant surgeon | $54.95 | $85.11 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $75.86 Typical High $114.82 | Professional | AS · PA/NP assist | $48.98 | $75.86 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,715.35 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $812.83 | Professional | None | $489.78 | $602.56 | $812.83 |
ConnectiCare Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $389.05 Median $524.81 Typical High $1,122.02 | Professional | None | $389.05 | $524.81 | $1,122.02 |
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 $177.83 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $177.83 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $70.79 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $269.15 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $53.70 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $35.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $363.08 |
Where Connecticut sits
The same service costs 7.1 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· 25th of 51
$589
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.