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 $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $776.25 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,318.26 Typical High $1,949.84 | Professional | None | $676.08 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,949.84 Typical High $2,951.21 | Professional | 50 · Both sides | $1,000.00 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $208.93 Typical High $309.03 | Professional | 80 · Assistant surgeon | $107.15 | $208.93 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $181.97 Typical High $275.42 | Professional | AS · PA/NP assist | $93.33 | $181.97 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,318.26 | $1,659.59 |
ConnectiCare Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,412.54 | Professional | None | $794.33 | $1,174.90 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $1,905.46 | Professional | None | $562.34 | $1,096.48 | $1,905.46 |
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 $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $389.05 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $77.62 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $549.54 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 7.2 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· 13th of 51
$1,202
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.