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 $1,318.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,318.26 | $2,041.74 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $11,748.98 Typical High $13,803.84 | Facility | None | $3,981.07 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,630.27 Typical High $3,890.45 | Professional | 50 · Both sides | $1,621.81 | $2,630.27 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $275.42 Typical High $416.87 | Professional | 80 · Assistant surgeon | $173.78 | $275.42 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $245.47 Typical High $363.08 | Professional | AS · PA/NP assist | $151.36 | $245.47 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,819.70 | $2,884.03 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Professional | None | $1,862.09 | $1,862.09 | $2,041.74 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $3,630.78 | Professional | None | $1,096.48 | $1,513.56 | $3,630.78 |
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 $660.69 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $660.69 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $263.03 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $977.24 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $131.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $912.01 | $1,445.44 | $1,445.44 |
Where Connecticut sits
The same service costs 5.9 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
$1,905
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.