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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,089.30 | $3,890.45 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $23,442.29 Typical High $28,183.83 | Facility | None | $7,585.78 | $23,442.29 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $4,570.88 | Professional | None | $2,344.23 | $3,467.37 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $2,187.76 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,445.44 | $2,187.76 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $562.34 Typical High $707.95 | Professional | 80 · Assistant surgeon | $371.54 | $562.34 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $489.78 Typical High $616.60 | Professional | AS · PA/NP assist | $323.59 | $489.78 | $616.60 |
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 $2,754.23 Median $3,548.13 Typical High $5,888.44 | Professional | None | $2,754.23 | $3,548.13 | $5,888.44 |
ConnectiCare Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,786.30 | Professional | None | $3,548.13 | $3,548.13 | $4,786.30 |
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 $2,398.83 Median $3,467.37 Typical High $7,762.47 | Professional | None | $2,398.83 | $3,467.37 | $7,762.47 |
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 $1,230.27 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,230.27 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $489.78 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,862.09 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $371.54 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $245.47 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,691.53 | $2,691.53 |
Where Connecticut sits
The same service costs 6.0 times more in Alaska 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· 15th of 51
$3,548
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.