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 $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,238.72 | $2,238.72 |
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 $1,348.96 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,348.96 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $389.05 Typical High $524.81 | Professional | 80 · Assistant surgeon | $213.80 | $389.05 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $338.84 Typical High $457.09 | Professional | AS · PA/NP assist | $186.21 | $338.84 | $457.09 |
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 $1,949.84 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,949.84 | $2,238.72 | $3,235.94 |
ConnectiCare Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,584.89 | $2,089.30 | $2,454.71 |
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 $1,122.02 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,122.02 | $2,041.74 | $3,890.45 |
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 $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $295.12 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,096.48 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $223.87 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 19.5 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· 16th of 51
$2,239
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.