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 $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,584.89 | $1,584.89 |
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 $1,000.00 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,380.38 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,089.30 Typical High $3,630.78 | Professional | 50 · Both sides | $1,513.56 | $2,089.30 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $223.87 Typical High $380.19 | Professional | 80 · Assistant surgeon | $162.18 | $223.87 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $194.98 Typical High $338.84 | Professional | AS · PA/NP assist | $141.25 | $194.98 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $19,498.45 Typical High $23,988.33 | Facility | None | $851.14 | $19,498.45 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,698.24 | $2,570.40 |
ConnectiCare Setting Professional Modifier None Typical Low $831.76 Median $1,513.56 Typical High $1,819.70 | Professional | None | $831.76 | $1,513.56 | $1,819.70 |
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 $645.65 Median $1,348.96 Typical High $2,089.30 | Professional | None | $645.65 | $1,348.96 | $2,089.30 |
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 $549.54 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $218.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $812.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $758.58 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 27th of 51
$1,514
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.