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 $2,511.89 Median $4,265.80 Typical High $4,265.80 | Professional | None | $2,511.89 | $4,265.80 | $4,265.80 |
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 $2,454.71 Median $3,981.07 Typical High $5,495.41 | Professional | None | $2,454.71 | $3,981.07 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,344.23 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,548.82 | $2,344.23 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $602.56 Typical High $891.25 | Professional | 80 · Assistant surgeon | $389.05 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $524.81 Typical High $776.25 | Professional | AS · PA/NP assist | $338.84 | $524.81 | $776.25 |
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 $3,467.37 Median $3,890.45 Typical High $6,165.95 | Professional | None | $3,467.37 | $3,890.45 | $6,165.95 |
ConnectiCare Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,897.79 | Professional | None | $4,265.80 | $4,265.80 | $4,897.79 |
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 $2,344.23 Median $3,467.37 Typical High $8,317.64 | Professional | None | $2,344.23 | $3,467.37 | $8,317.64 |
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 $1,258.93 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,258.93 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $501.19 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,905.46 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $380.19 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $251.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,951.21 | $2,951.21 |
Where Connecticut sits
The same service costs 10.0 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· 13th of 51
$4,074
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.