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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,630.27 | $2,630.27 |
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 $1,479.11 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,479.11 | $2,754.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $446.68 Typical High $602.56 | Professional | 80 · Assistant surgeon | $239.88 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $389.05 Typical High $524.81 | Professional | AS · PA/NP assist | $208.93 | $389.05 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,762.47 Typical High $9,772.37 | Facility | None | $851.14 | $7,762.47 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,454.71 | $2,754.23 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,570.40 | $2,884.03 |
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 $1,288.25 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,288.25 | $2,344.23 | $4,365.16 |
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 $851.14 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $851.14 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $346.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,288.25 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $257.04 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $169.82 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,819.70 | $1,819.70 |
Where Connecticut sits
The same service costs 20.4 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· 11th of 51
$2,630
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.