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 $3,388.44 Median $5,754.40 Typical High $5,754.40 | Professional | None | $3,388.44 | $5,754.40 | $5,754.40 |
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 $3,388.44 Median $5,754.40 Typical High $8,128.31 | Professional | None | $3,388.44 | $5,754.40 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $933.25 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $537.03 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $812.83 Typical High $1,148.15 | Professional | AS · PA/NP assist | $467.74 | $812.83 | $1,148.15 |
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 $4,073.80 Median $5,623.41 Typical High $8,709.64 | Professional | None | $4,073.80 | $5,623.41 | $8,709.64 |
ConnectiCare Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,456.54 | Professional | None | $5,623.41 | $5,623.41 | $6,456.54 |
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 $3,630.78 Median $5,754.40 Typical High $11,748.98 | Professional | None | $3,630.78 | $5,754.40 | $11,748.98 |
4 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 $1,862.09 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,862.09 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $741.31 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $2,818.38 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $2,630.27 | $3,981.07 | $3,981.07 |
Where Connecticut sits
The same service costs 7.6 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
$5,754
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.