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 $3,467.37 Median $5,370.32 Typical High $5,370.32 | Professional | None | $3,467.37 | $5,370.32 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $16,595.87 Typical High $19,952.62 | Facility | None | $1,000.00 | $16,595.87 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $5,370.32 Typical High $7,585.78 | Professional | None | $3,090.30 | $5,370.32 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $851.14 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $501.19 | $851.14 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $758.58 Typical High $1,047.13 | Professional | AS · PA/NP assist | $436.52 | $758.58 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $8,128.31 | Professional | None | $3,801.89 | $5,248.07 | $8,128.31 |
ConnectiCare Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,888.44 | Professional | None | $5,248.07 | $5,248.07 | $5,888.44 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $5,370.32 Typical High $10,964.78 | Professional | None | $3,388.44 | $5,370.32 | $10,964.78 |
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 $1,737.80 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $1,737.80 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $691.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $2,570.40 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $524.81 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $346.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,398.83 | $3,715.35 | $3,715.35 |
Where Connecticut sits
The same service costs 7.1 times more in Alaska than in Arkansas. 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· 11th of 51
$5,370
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.