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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | None | $812.83 | $1,174.90 | $1,174.90 |
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 $758.58 Median $1,230.27 Typical High $1,778.28 | Professional | None | $758.58 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | 62 · Two surgeons | $478.63 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $120.23 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $165.96 Typical High $251.19 | Professional | AS · PA/NP assist | $107.15 | $165.96 | $251.19 |
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 $1,174.90 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,174.90 | $1,819.70 |
ConnectiCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,445.44 | $1,479.11 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,905.46 | Professional | None | $812.83 | $1,071.52 | $1,905.46 |
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 $407.38 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $407.38 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $616.60 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $575.44 | $831.76 | $831.76 |
Where Connecticut sits
The same service costs 8.5 times more in Oklahoma 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
$1,202
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.