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 $1,096.48 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,949.84 | $1,949.84 |
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 $1,023.29 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,023.29 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,951.21 Typical High $3,981.07 | Professional | 50 · Both sides | $1,548.82 | $2,951.21 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $316.23 Typical High $416.87 | Professional | 80 · Assistant surgeon | $165.96 | $316.23 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $144.54 | $275.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,549.93 Typical High $12,022.64 | Facility | None | $851.14 | $9,549.93 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,698.24 | $2,630.27 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,584.89 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,621.81 Typical High $3,019.95 | Professional | None | $870.96 | $1,621.81 | $3,019.95 |
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 $549.54 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $549.54 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $218.78 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $831.76 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $165.96 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $109.65 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $776.25 | $1,380.38 | $1,380.38 |
Where Connecticut sits
The same service costs 8.7 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
$1,950
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.