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 $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $776.25 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,380.38 Typical High $1,862.09 | Professional | None | $724.44 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $218.78 Typical High $302.00 | Professional | 80 · Assistant surgeon | $114.82 | $218.78 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $190.55 Typical High $263.03 | Professional | AS · PA/NP assist | $100.00 | $190.55 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,168.69 | Facility | None | $741.31 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,202.26 | $1,949.84 |
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 $954.99 Median $1,122.02 Typical High $1,288.25 | Professional | None | $954.99 | $1,122.02 | $1,288.25 |
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 $602.56 Median $1,148.15 Typical High $2,238.72 | Professional | None | $602.56 | $1,148.15 | $2,238.72 |
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 $380.19 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $380.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $114.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $77.62 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $537.03 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 8.3 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
$1,380
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.