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 $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | None | $724.44 | $1,096.48 | $1,096.48 |
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 $691.83 Median $1,348.96 Typical High $1,819.70 | Professional | None | $691.83 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $213.80 Typical High $288.40 | Professional | 80 · Assistant surgeon | $112.20 | $213.80 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $190.55 Typical High $251.19 | Professional | AS · PA/NP assist | $97.72 | $190.55 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $6,309.57 Typical High $7,762.47 | Facility | None | $1,412.54 | $6,309.57 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
ConnectiCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,348.96 | $1,621.81 |
ConnectiCare Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,202.26 | Professional | None | $812.83 | $1,047.13 | $1,202.26 |
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 $645.65 Median $1,122.02 Typical High $2,511.89 | Professional | None | $645.65 | $1,122.02 | $2,511.89 |
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 $354.81 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $354.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $141.25 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $537.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $107.15 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $501.19 | $758.58 | $758.58 |
Where Connecticut sits
The same service costs 6.3 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· 12th of 51
$1,230
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.