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 $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $588.84 | Professional | None | $416.87 | $588.84 | $588.84 |
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 $389.05 Median $645.65 Typical High $891.25 | Professional | None | $389.05 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $389.05 Typical High $562.34 | Professional | 62 · Two surgeons | $239.88 | $389.05 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $97.72 Typical High $144.54 | Professional | 80 · Assistant surgeon | $61.66 | $97.72 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $85.11 Typical High $125.89 | Professional | AS · PA/NP assist | $53.70 | $85.11 | $125.89 |
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 $549.54 Median $660.69 Typical High $954.99 | Professional | None | $549.54 | $660.69 | $954.99 |
ConnectiCare Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | None | $724.44 | $724.44 | $758.58 |
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 $436.52 Median $602.56 Typical High $1,230.27 | Professional | None | $436.52 | $602.56 | $1,230.27 |
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 $199.53 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $199.53 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $302.00 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $60.26 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $39.81 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $281.84 | $407.38 | $407.38 |
Where Connecticut sits
The same service costs 10.2 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
$661
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.