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 $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | None | $758.58 | $1,148.15 | $1,148.15 |
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 $707.95 Median $977.24 Typical High $1,659.59 | Professional | None | $707.95 | $977.24 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $158.49 Typical High $263.03 | Professional | 80 · Assistant surgeon | $114.82 | $158.49 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $138.04 Typical High $229.09 | Professional | AS · PA/NP assist | $100.00 | $138.04 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $4,365.16 | Facility | None | $851.14 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,174.90 | $1,905.46 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,230.27 | $1,348.96 |
Health New England Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $707.95 Median $1,000.00 Typical High $1,949.84 | Professional | None | $707.95 | $1,000.00 | $1,949.84 |
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 $380.19 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $380.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $151.36 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $575.44 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $114.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $75.86 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $537.03 | $812.83 | $812.83 |
Where Connecticut sits
The same service costs 7.9 times more in Oklahoma than in Utah. 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· 29th of 51
$1,072
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.