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 $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 $11,481.54 Typical High $13,489.63 | Facility | None | $933.25 | $11,481.54 | $13,489.63 |
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 50 · Both sides Typical Low $1,071.52 Median $1,479.11 Typical High $2,398.83 | Professional | 50 · Both sides | $1,071.52 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $158.49 Typical High $257.04 | Professional | 80 · Assistant surgeon | $112.20 | $158.49 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $138.04 Typical High $223.87 | Professional | AS · PA/NP assist | $100.00 | $138.04 | $223.87 |
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 $977.24 Median $1,148.15 Typical High $1,905.46 | Professional | None | $977.24 | $1,148.15 | $1,905.46 |
ConnectiCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,202.26 | $1,202.26 | $1,348.96 |
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 $691.83 Median $933.25 Typical High $1,905.46 | Professional | None | $691.83 | $933.25 | $1,905.46 |
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 $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $151.36 | $234.42 | $234.42 |
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 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
$1,023
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.