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 $2,089.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,089.30 | $3,090.30 | $3,090.30 |
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 $1,737.80 Median $3,090.30 Typical High $4,073.80 | Professional | None | $1,737.80 | $3,090.30 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $489.78 Typical High $645.65 | Professional | 80 · Assistant surgeon | $275.42 | $489.78 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $436.52 Typical High $562.34 | Professional | AS · PA/NP assist | $239.88 | $436.52 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,818.38 Typical High $27,542.29 | Facility | None | $512.86 | $2,818.38 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $5,128.61 | Professional | None | $2,570.40 | $2,754.23 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,630.27 | $3,162.28 |
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 $1,412.54 Median $2,570.40 Typical High $5,754.40 | Professional | None | $1,412.54 | $2,570.40 | $5,754.40 |
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 $1,047.13 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,047.13 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,584.89 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $316.23 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $208.93 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,187.76 | $2,187.76 |
Where Connecticut sits
The same service costs 5.9 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· 12th of 51
$3,020
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.