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 $2,238.72 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,238.72 | $3,630.78 | $3,630.78 |
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 $2,238.72 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,238.72 | $3,162.28 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $489.78 Typical High $741.31 | Professional | 80 · Assistant surgeon | $354.81 | $489.78 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $426.58 Typical High $645.65 | Professional | AS · PA/NP assist | $309.03 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $5,370.32 | Professional | None | $2,818.38 | $2,951.21 | $5,370.32 |
ConnectiCare Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,168.69 | Professional | None | $3,162.28 | $3,162.28 | $4,168.69 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $7,244.36 | Professional | None | $1,995.26 | $3,019.95 | $7,244.36 |
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 $1,122.02 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,122.02 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $446.68 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,659.59 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $338.84 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $223.87 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $2,570.40 |
Where Connecticut sits
The same service costs 8.1 times more in Alaska than in Texas. 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· 15th of 51
$3,311
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.