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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $954.99 | Professional | None | $630.96 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,122.02 Typical High $1,548.82 | Professional | None | $562.34 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $177.83 Typical High $251.19 | Professional | 80 · Assistant surgeon | $89.13 | $177.83 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $144.54 Typical High $218.78 | Professional | AS · PA/NP assist | $77.62 | $144.54 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $2,398.83 | Facility | None | $741.31 | $1,862.09 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,479.11 | Professional | None | $660.69 | $851.14 | $1,479.11 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Professional | None | $691.83 | $851.14 | $1,047.13 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $446.68 Median $891.25 Typical High $1,698.24 | Professional | None | $446.68 | $891.25 | $1,698.24 |
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 $316.23 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $316.23 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $478.63 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $95.50 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $63.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $446.68 | $660.69 | $660.69 |
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· 11th of 51
$1,047
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.