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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,344.23 | $2,344.23 |
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 $1,445.44 Median $2,754.23 Typical High $3,630.78 | Professional | None | $1,445.44 | $2,754.23 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $3,981.07 Typical High $5,370.32 | Professional | 50 · Both sides | $2,137.96 | $3,981.07 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $426.58 Typical High $575.44 | Professional | 80 · Assistant surgeon | $229.09 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $371.54 Typical High $501.19 | Professional | AS · PA/NP assist | $199.53 | $371.54 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $5,370.32 | Facility | None | $851.14 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,454.71 | $3,548.13 |
ConnectiCare Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,659.59 | $2,238.72 | $2,691.53 |
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 $1,202.26 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,202.26 | $2,238.72 | $4,168.69 |
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 $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $812.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $323.59 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,202.26 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,621.81 | $1,621.81 |
Where Connecticut sits
The same service costs 16.2 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· 15th of 51
$2,399
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.