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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | None | $691.83 | $1,047.13 | $1,047.13 |
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 $660.69 Median $1,258.93 Typical High $1,698.24 | Professional | None | $660.69 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $977.24 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $104.71 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $91.20 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,288.25 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,348.96 | Professional | None | $794.33 | $1,047.13 | $1,348.96 |
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 $549.54 Median $1,096.48 Typical High $1,862.09 | Professional | None | $549.54 | $1,096.48 | $1,862.09 |
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 $338.84 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $338.84 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $138.04 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $512.86 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $102.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $69.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $741.31 |
Where Connecticut sits
The same service costs 8.7 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· 14th of 51
$1,230
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.