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 $891.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $891.25 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $11,748.98 Typical High $13,803.84 | Facility | None | $3,801.89 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,187.76 | Professional | None | $977.24 | $1,479.11 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $234.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $154.88 | $234.42 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $204.17 Typical High $309.03 | Professional | AS · PA/NP assist | $138.04 | $204.17 | $309.03 |
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 $1,348.96 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,479.11 | $2,511.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,584.89 | $1,995.26 |
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 $933.25 Median $1,380.38 Typical High $3,311.31 | Professional | None | $933.25 | $1,380.38 | $3,311.31 |
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 $549.54 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $549.54 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $218.78 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $812.83 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $165.96 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $109.65 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $758.58 | $1,174.90 | $1,174.90 |
Where Connecticut sits
The same service costs 6.8 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· 16th of 51
$1,585
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.