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 $616.60 Median $891.25 Typical High $891.25 | Professional | None | $616.60 | $891.25 | $891.25 |
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 $588.84 Median $1,071.52 Typical High $1,479.11 | Professional | None | $588.84 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,548.82 Typical High $2,187.76 | Professional | 50 · Both sides | $870.96 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $93.33 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $81.28 | $144.54 | $204.17 |
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 $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 $691.83 Median $912.01 Typical High $1,318.26 | Professional | None | $691.83 | $912.01 | $1,318.26 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $467.74 Median $954.99 Typical High $1,621.81 | Professional | None | $467.74 | $954.99 | $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 $302.00 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $302.00 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $457.09 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $426.58 | $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· 15th 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.