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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $741.31 | Professional | None | $446.68 | $457.09 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $776.25 | Professional | None | $436.52 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $831.76 Typical High $1,148.15 | Professional | 50 · Both sides | $645.65 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $89.13 Typical High $123.03 | Professional | 80 · Assistant surgeon | $69.18 | $89.13 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $77.62 Typical High $107.15 | Professional | AS · PA/NP assist | $60.26 | $77.62 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,412.54 Typical High $2,511.89 | Facility | None | $794.33 | $1,412.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $1,096.48 | Professional | None | $398.11 | $676.08 | $1,096.48 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $870.96 | Professional | None | $691.83 | $707.95 | $870.96 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $1,380.38 | Professional | None | $288.40 | $588.84 | $1,380.38 |
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 $223.87 Median $229.09 Typical High $371.54 | Professional | 52 · Reduced service | $223.87 | $229.09 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $147.91 | Professional | 53 · Discontinued | $91.20 | $91.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $549.54 | Professional | 54 · Surgery only | $338.84 | $346.74 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $69.18 Typical High $109.65 | Professional | 55 · Aftercare only | $67.61 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $74.13 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $323.59 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $316.23 | $323.59 | $512.86 |
Where Connecticut sits
The same service costs 5.1 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· 12th of 51
$646
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.