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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,174.90 | Professional | None | $794.33 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $23,442.29 Typical High $28,183.83 | Facility | None | $7,585.78 | $23,442.29 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,621.81 | Professional | None | $724.44 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $173.78 Typical High $263.03 | Professional | 80 · Assistant surgeon | $112.20 | $173.78 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $151.36 Typical High $229.09 | Professional | AS · PA/NP assist | $100.00 | $151.36 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,471.29 Typical High $13,182.57 | Facility | None | $851.14 | $10,471.29 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,318.26 | $1,862.09 |
ConnectiCare Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,511.38 | Facility | None | $7,585.78 | $7,585.78 | $8,511.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,412.54 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,511.89 | Professional | None | $870.96 | $1,202.26 | $2,511.89 |
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 $416.87 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $416.87 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $165.96 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $616.60 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $83.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $575.44 | $831.76 | $831.76 |
Where Connecticut sits
The same service costs 11.0 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· 21st of 51
$1,259
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.