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 $562.34 Median $851.14 Typical High $851.14 | Professional | None | $562.34 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $21,877.62 Typical High $28,183.83 | Facility | None | $3,715.35 | $21,877.62 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,412.54 | Professional | None | $537.03 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,479.11 Typical High $2,137.96 | Professional | 50 · Both sides | $776.25 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $83.18 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $138.04 Typical High $199.53 | Professional | AS · PA/NP assist | $72.44 | $138.04 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,549.93 Typical High $12,022.64 | Facility | None | $851.14 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,348.96 | Professional | None | $794.33 | $912.01 | $1,348.96 |
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 $660.69 Median $851.14 Typical High $977.24 | Professional | None | $660.69 | $851.14 | $977.24 |
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 $436.52 Median $831.76 Typical High $1,548.82 | Professional | None | $436.52 | $831.76 | $1,548.82 |
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 $281.84 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $281.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $112.20 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $56.23 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $602.56 |
Where Connecticut sits
The same service costs 7.8 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
$955
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.