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 $676.08 Median $1,096.48 Typical High $1,096.48 | Professional | None | $676.08 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $1,380.38 | Professional | None | $537.03 | $954.99 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $147.91 Typical High $218.78 | Professional | 80 · Assistant surgeon | $87.10 | $147.91 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $131.83 Typical High $190.55 | Professional | AS · PA/NP assist | $75.86 | $131.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,165.95 Typical High $7,762.47 | Facility | None | $741.31 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | None | $851.14 | $1,047.13 | $1,513.56 |
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 $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,737.80 | Professional | None | $588.84 | $870.96 | $1,737.80 |
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 $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $338.84 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $134.90 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $501.19 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $100.00 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $67.61 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $467.74 | $758.58 | $758.58 |
Where Connecticut sits
The same service costs 8.1 times more in Oklahoma than in Utah. 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· 19th of 51
$1,096
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.