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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $478.63 | Professional | None | $338.84 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $14,454.40 Typical High $19,498.45 | Facility | None | $5,754.40 | $14,454.40 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $741.31 | Professional | None | $316.23 | $501.19 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $77.62 Typical High $117.49 | Professional | 80 · Assistant surgeon | $50.12 | $77.62 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $67.61 Typical High $102.33 | Professional | AS · PA/NP assist | $43.65 | $67.61 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $27,542.29 | Facility | None | $512.86 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Professional | None | $446.68 | $537.03 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $1,000.00 | Professional | None | $346.74 | $478.63 | $1,000.00 |
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 $162.18 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $162.18 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $64.57 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $245.47 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $48.98 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $32.36 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $229.09 | $331.13 | $331.13 |
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· 18th of 51
$537
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.