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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,230.27 | Professional | None | $724.44 | $933.25 | $1,230.27 |
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 $758.58 Median $1,096.48 Typical High $1,513.56 | Professional | None | $758.58 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $120.23 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $147.91 Typical High $213.80 | Professional | AS · PA/NP assist | $104.71 | $147.91 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,737.80 | Professional | None | $891.25 | $1,047.13 | $1,737.80 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,230.27 | $1,479.11 |
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 $537.03 Median $1,000.00 Typical High $2,187.76 | Professional | None | $537.03 | $1,000.00 | $2,187.76 |
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 $389.05 Median $467.74 Typical High $616.60 | Professional | 52 · Reduced service | $389.05 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $186.21 Typical High $245.47 | Professional | 53 · Discontinued | $154.88 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $691.83 Typical High $912.01 | Professional | 54 · Surgery only | $588.84 | $691.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $141.25 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $93.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $77.62 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $645.65 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $549.54 | $645.65 | $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· 15th of 51
$1,072
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.