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 $416.87 Median $645.65 Typical High $645.65 | Professional | None | $416.87 | $645.65 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $954.99 | Professional | None | $316.23 | $524.81 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $776.25 Typical High $1,412.54 | Professional | 50 · Both sides | $478.63 | $776.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $83.18 Typical High $151.36 | Professional | 80 · Assistant surgeon | $51.29 | $83.18 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $72.44 Typical High $131.83 | Professional | AS · PA/NP assist | $44.67 | $72.44 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,570.40 | Facility | None | $741.31 | $1,995.26 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $954.99 | Professional | None | $549.54 | $588.84 | $954.99 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $758.58 | Professional | None | $363.08 | $478.63 | $758.58 |
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 $269.15 Median $478.63 Typical High $1,071.52 | Professional | None | $269.15 | $478.63 | $1,071.52 |
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 $208.93 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $208.93 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $83.18 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $316.23 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $41.69 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $295.12 | $446.68 | $446.68 |
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
$550
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.