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 $457.09 Median $537.03 Typical High $537.03 | Professional | None | $457.09 | $537.03 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $741.31 Typical High $933.25 | Professional | None | $389.05 | $741.31 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $117.49 Typical High $151.36 | Professional | 80 · Assistant surgeon | $58.88 | $117.49 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $102.33 Typical High $131.83 | Professional | AS · PA/NP assist | $51.29 | $102.33 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,025.60 Typical High $7,413.10 | Facility | None | $741.31 | $6,025.60 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,047.13 | Professional | None | $501.19 | $602.56 | $1,047.13 |
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 $616.60 Median $616.60 Typical High $812.83 | Professional | None | $616.60 | $616.60 | $812.83 |
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 $416.87 Median $660.69 Typical High $1,380.38 | Professional | None | $416.87 | $660.69 | $1,380.38 |
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 $229.09 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $371.54 |
Where Connecticut sits
The same service costs 5.4 times more in Alaska than in New York. 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· 20th of 51
$851
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.