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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $13,803.84 Typical High $16,218.10 | Facility | None | $954.99 | $13,803.84 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,047.13 | $2,041.74 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $169.82 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $288.40 Typical High $380.19 | Professional | AS · PA/NP assist | $147.91 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,659.59 | $2,344.23 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,548.82 | $1,737.80 |
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 $977.24 Median $1,737.80 Typical High $3,801.89 | Professional | None | $977.24 | $1,737.80 | $3,801.89 |
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 $537.03 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $537.03 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $107.15 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $758.58 | $1,071.52 | $1,071.52 |
Where Connecticut sits
The same service costs 6.2 times more in Alaska than in Texas. 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· 13th of 51
$1,820
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.