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 $758.58 Median $1,122.02 Typical High $1,122.02 | Professional | None | $758.58 | $1,122.02 | $1,122.02 |
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 $676.08 Median $1,258.93 Typical High $1,737.80 | Professional | None | $676.08 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $107.15 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $173.78 Typical High $245.47 | Professional | AS · PA/NP assist | $93.33 | $173.78 | $245.47 |
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 $794.33 Median $1,071.52 Typical High $1,258.93 | Professional | None | $794.33 | $1,071.52 | $1,258.93 |
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 $575.44 Median $1,071.52 Typical High $1,995.26 | Professional | None | $575.44 | $1,071.52 | $1,995.26 |
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 $380.19 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $380.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $151.36 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $562.34 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $75.86 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $524.81 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 8.5 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· 20th of 51
$1,148
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.