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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $1,548.82 | Professional | None | $933.25 | $1,513.56 | $1,548.82 |
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 $954.99 Median $1,737.80 Typical High $2,344.23 | Professional | None | $954.99 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $151.36 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $234.42 Typical High $323.59 | Professional | AS · PA/NP assist | $131.83 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,467.37 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,584.89 | $2,454.71 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,479.11 | $1,778.28 |
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 $758.58 Median $1,479.11 Typical High $2,818.38 | Professional | None | $758.58 | $1,479.11 | $2,818.38 |
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 $489.78 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $489.78 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $194.98 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $97.72 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $676.08 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 7.6 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
$1,698
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.