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 $630.96 Median $933.25 Typical High $933.25 | Professional | None | $630.96 | $933.25 | $933.25 |
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 $588.84 Median $1,096.48 Typical High $1,548.82 | Professional | None | $588.84 | $1,096.48 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,659.59 Typical High $2,344.23 | Professional | 50 · Both sides | $851.14 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $173.78 Typical High $245.47 | Professional | 80 · Assistant surgeon | $91.20 | $173.78 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $151.36 Typical High $218.78 | Professional | AS · PA/NP assist | $79.43 | $151.36 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,000.00 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,479.11 | Professional | None | $912.01 | $1,000.00 | $1,479.11 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,071.52 | Professional | None | $707.95 | $954.99 | $1,071.52 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $489.78 Median $912.01 Typical High $1,698.24 | Professional | None | $489.78 | $912.01 | $1,698.24 |
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 $316.23 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $316.23 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $478.63 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $95.50 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $63.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $446.68 | $645.65 | $645.65 |
Where Connecticut sits
The same service costs 8.3 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· 19th of 51
$1,023
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.