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 $602.56 Median $891.25 Typical High $891.25 | Professional | None | $602.56 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,479.11 | Professional | None | $537.03 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,584.89 Typical High $2,238.72 | Professional | 50 · Both sides | $794.33 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $85.11 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $74.13 | $147.91 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $2,691.53 | Facility | None | $851.14 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,445.44 | Professional | None | $933.25 | $1,230.27 | $1,445.44 |
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 $676.08 Median $912.01 Typical High $1,288.25 | Professional | None | $676.08 | $912.01 | $1,288.25 |
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 $467.74 Median $933.25 Typical High $1,621.81 | Professional | None | $467.74 | $933.25 | $1,621.81 |
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 $295.12 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $120.23 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $60.26 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $616.60 | $616.60 |
Where Connecticut sits
The same service costs 7.4 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· 12th of 51
$1,072
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.