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 $776.25 Typical High $776.25 | Professional | None | $562.34 | $776.25 | $776.25 |
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 $524.81 Median $1,000.00 Typical High $1,412.54 | Professional | None | $524.81 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,479.11 Typical High $2,089.30 | Professional | 50 · Both sides | $758.58 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $81.28 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $138.04 Typical High $194.98 | Professional | AS · PA/NP assist | $70.79 | $138.04 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
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 $645.65 Median $831.76 Typical High $977.24 | Professional | None | $645.65 | $831.76 | $977.24 |
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 $446.68 Median $831.76 Typical High $1,548.82 | Professional | None | $446.68 | $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 $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $281.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $112.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $56.23 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $398.11 | $549.54 | $549.54 |
Where Connecticut sits
The same service costs 8.9 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
$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.