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 $724.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $724.44 | $1,000.00 | $1,000.00 |
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 $724.44 Median $1,202.26 Typical High $1,621.81 | Professional | None | $724.44 | $1,202.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $194.98 Typical High $257.04 | Professional | 80 · Assistant surgeon | $114.82 | $194.98 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $169.82 Typical High $229.09 | Professional | AS · PA/NP assist | $102.33 | $169.82 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $6,309.57 Typical High $7,762.47 | Facility | None | $1,412.54 | $6,309.57 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,148.15 | $1,737.80 |
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 $870.96 Median $1,071.52 Typical High $1,230.27 | Professional | None | $870.96 | $1,071.52 | $1,230.27 |
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 $588.84 Median $1,096.48 Typical High $2,089.30 | Professional | None | $588.84 | $1,096.48 | $2,089.30 |
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 $363.08 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $363.08 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $144.54 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $537.03 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $107.15 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $72.44 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $501.19 | $691.83 | $691.83 |
Where Connecticut sits
The same service costs 17.4 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· 16th of 51
$1,202
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.