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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,258.93 | Professional | None | $724.44 | $1,047.13 | $1,258.93 |
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 $851.14 Median $1,513.56 Typical High $2,089.30 | Professional | None | $851.14 | $1,513.56 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $239.88 Typical High $331.13 | Professional | 80 · Assistant surgeon | $131.83 | $239.88 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $117.49 | $208.93 | $295.12 |
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 $851.14 Median $1,148.15 Typical High $1,621.81 | Professional | None | $851.14 | $1,148.15 | $1,621.81 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,318.26 | $1,445.44 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,148.15 Typical High $2,454.71 | Professional | None | $645.65 | $1,148.15 | $2,454.71 |
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 $371.54 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $371.54 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $147.91 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $562.34 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $112.20 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $74.13 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $524.81 | $724.44 | $870.96 |
Where Connecticut sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$1,259
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.