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 $707.95 Median $851.14 Typical High $851.14 | Professional | None | $707.95 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,380.38 Typical High $1,621.81 | Professional | None | $691.83 | $1,380.38 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $223.87 Typical High $263.03 | Professional | 80 · Assistant surgeon | $112.20 | $223.87 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $194.98 Typical High $229.09 | Professional | AS · PA/NP assist | $97.72 | $194.98 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,659.59 | Professional | None | $676.08 | $870.96 | $1,659.59 |
ConnectiCare Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,548.82 | Professional | None | $831.76 | $831.76 | $1,548.82 |
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 $602.56 Median $1,174.90 Typical High $2,398.83 | Professional | None | $602.56 | $1,174.90 | $2,398.83 |
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 $354.81 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $602.56 |
Where Connecticut sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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· 18th of 51
$1,380
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.