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 $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,230.27 | $2,398.83 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $371.54 Typical High $524.81 | Professional | 80 · Assistant surgeon | $194.98 | $371.54 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $323.59 Typical High $457.09 | Professional | AS · PA/NP assist | $169.82 | $323.59 | $457.09 |
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 $2,041.74 Median $2,187.76 Typical High $3,235.94 | Professional | None | $2,041.74 | $2,187.76 | $3,235.94 |
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 $1,548.82 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,548.82 | $2,089.30 | $2,398.83 |
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 $1,071.52 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,071.52 | $2,041.74 | $3,715.35 |
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 $676.08 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $676.08 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $269.15 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,023.29 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $204.17 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $134.90 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,318.26 | $1,318.26 |
Where Connecticut sits
The same service costs 17.0 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
$2,291
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.