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 $630.96 Median $891.25 Typical High $891.25 | Professional | None | $630.96 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $15,848.93 Typical High $17,782.79 | Facility | None | $3,235.94 | $15,848.93 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $1,348.96 | Professional | None | $549.54 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $575.44 Typical High $851.14 | Professional | 62 · Two surgeons | $346.74 | $575.44 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $144.54 Typical High $218.78 | Professional | 80 · Assistant surgeon | $87.10 | $144.54 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $128.82 Typical High $190.55 | Professional | AS · PA/NP assist | $77.62 | $128.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,445.44 | Professional | None | $812.83 | $933.25 | $1,445.44 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,047.13 | Professional | None | $1,023.29 | $1,023.29 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,698.24 | Professional | None | $562.34 | $741.31 | $1,698.24 |
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 $316.23 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $316.23 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $478.63 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $95.50 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $63.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $446.68 | $616.60 | $616.60 |
Where Connecticut sits
The same service costs 8.1 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· 23rd of 51
$955
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.