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 $1,096.48 Typical High $1,096.48 | Professional | None | $724.44 | $1,096.48 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,584.89 | Professional | None | $676.08 | $933.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $147.91 Typical High $245.47 | Professional | 80 · Assistant surgeon | $107.15 | $147.91 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $128.82 Typical High $213.80 | Professional | AS · PA/NP assist | $93.33 | $128.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $4,677.35 | Facility | None | $1,000.00 | $3,548.13 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $933.25 | $1,096.48 | $1,778.28 |
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 $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,148.15 | $1,148.15 | $1,258.93 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,819.70 | Professional | None | $660.69 | $933.25 | $1,819.70 |
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 $363.08 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $363.08 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $144.54 | $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 $72.44 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $72.44 | $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 5.8 times more in Alaska 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· 32nd of 51
$1,000
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.