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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,584.89 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,174.90 | $2,187.76 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $3,235.94 Typical High $4,168.69 | Professional | 50 · Both sides | $1,778.28 | $3,235.94 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,348.96 Typical High $1,778.28 | Professional | 62 · Two surgeons | $741.31 | $1,348.96 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $346.74 Typical High $446.68 | Professional | 80 · Assistant surgeon | $190.55 | $346.74 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $302.00 Typical High $389.05 | Professional | AS · PA/NP assist | $165.96 | $302.00 | $389.05 |
ConnectiCare Setting Facility Modifier None Typical Low $954.99 Median $6,025.60 Typical High $6,165.95 | Facility | None | $954.99 | $6,025.60 | $6,165.95 |
ConnectiCare Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,187.76 | Professional | None | $831.76 | $1,348.96 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $4,466.84 | Professional | None | $1,174.90 | $1,584.89 | $4,466.84 |
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 $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $794.33 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $316.23 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,174.90 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $158.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,479.11 | $1,479.11 |
Where Connecticut sits
The same service costs 8.3 times more in Wyoming 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· 18th of 51
$2,138
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.