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 $316.23 Median $446.68 Typical High $457.09 | Professional | None | $316.23 | $446.68 | $457.09 |
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 $275.42 Median $478.63 Typical High $676.08 | Professional | None | $275.42 | $478.63 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $72.44 Typical High $107.15 | Professional | 80 · Assistant surgeon | $43.65 | $72.44 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $63.10 Typical High $93.33 | Professional | AS · PA/NP assist | $38.90 | $63.10 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $4,466.84 | Facility | None | $851.14 | $3,630.78 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $741.31 | Professional | None | $407.38 | $501.19 | $741.31 |
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 $562.34 Median $562.34 Typical High $602.56 | Professional | None | $562.34 | $562.34 | $602.56 |
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 $338.84 Median $467.74 Typical High $954.99 | Professional | None | $338.84 | $467.74 | $954.99 |
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 $158.49 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $234.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $47.86 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $31.62 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $218.78 | $309.03 | $309.03 |
Where Connecticut sits
The same service costs 11.2 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· 22nd of 51
$513
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.