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 $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,230.27 | Professional | None | $676.08 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $28,183.83 | Facility | None | $2,754.23 | $4,168.69 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $954.99 Typical High $1,445.44 | Professional | None | $660.69 | $954.99 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $151.36 Typical High $229.09 | Professional | 80 · Assistant surgeon | $104.71 | $151.36 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $134.90 Typical High $204.17 | Professional | AS · PA/NP assist | $91.20 | $134.90 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $4,570.88 Typical High $5,888.44 | Facility | None | $1,412.54 | $4,570.88 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $891.25 | $1,047.13 | $1,479.11 |
ConnectiCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,348.96 | $1,621.81 |
ConnectiCare Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,380.38 | Professional | None | $776.25 | $1,096.48 | $1,380.38 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,737.80 | Professional | None | $489.78 | $912.01 | $1,737.80 |
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 $346.74 Median $512.86 Typical High $616.60 | Professional | 52 · Reduced service | $346.74 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $204.17 Typical High $245.47 | Professional | 53 · Discontinued | $138.04 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $524.81 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $104.71 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $69.18 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $489.78 | $707.95 | $851.14 |
Where Connecticut sits
The same service costs 6.2 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· 11th of 51
$1,023
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.