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 $691.83 Median $954.99 Typical High $954.99 | Professional | None | $691.83 | $954.99 | $954.99 |
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 $645.65 Median $1,202.26 Typical High $1,698.24 | Professional | None | $645.65 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,778.28 Typical High $2,570.40 | Professional | 50 · Both sides | $954.99 | $1,778.28 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $190.55 Typical High $269.15 | Professional | 80 · Assistant surgeon | $100.00 | $190.55 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $165.96 Typical High $239.88 | Professional | AS · PA/NP assist | $89.13 | $165.96 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $5,495.41 | Facility | None | $851.14 | $4,365.16 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $933.25 | $1,071.52 | $1,621.81 |
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 $776.25 Median $977.24 Typical High $1,148.15 | Professional | None | $776.25 | $977.24 | $1,148.15 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,862.09 | Professional | None | $512.86 | $1,000.00 | $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 $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $338.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $512.86 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $102.33 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $69.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $478.63 | $660.69 | $660.69 |
Where Connecticut sits
The same service costs 8.5 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· 13th of 51
$1,148
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.