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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $21,877.62 Typical High $28,183.83 | Facility | None | $7,585.78 | $21,877.62 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,905.46 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,818.38 Typical High $3,801.89 | Professional | 50 · Both sides | $1,479.11 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $309.03 Typical High $407.38 | Professional | 80 · Assistant surgeon | $158.49 | $309.03 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $138.04 | $263.03 | $354.81 |
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 $1,412.54 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,659.59 | $2,570.40 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,513.56 | $1,819.70 |
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 $812.83 Median $1,584.89 Typical High $2,951.21 | Professional | None | $812.83 | $1,584.89 | $2,951.21 |
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 $512.86 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $512.86 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $204.17 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $758.58 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $102.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $707.95 | $954.99 | $954.99 |
Where Connecticut sits
The same service costs 13.8 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
$1,778
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.