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 $537.03 Median $741.31 Typical High $741.31 | Professional | None | $537.03 | $741.31 | $741.31 |
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 $416.87 Median $724.44 Typical High $954.99 | Professional | None | $416.87 | $724.44 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $1,071.52 Typical High $1,412.54 | Professional | 50 · Both sides | $616.60 | $1,071.52 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $114.82 Typical High $151.36 | Professional | 80 · Assistant surgeon | $66.07 | $114.82 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $100.00 Typical High $131.83 | Professional | AS · PA/NP assist | $57.54 | $100.00 | $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 $660.69 Median $724.44 Typical High $1,288.25 | Professional | None | $660.69 | $724.44 | $1,288.25 |
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 $512.86 Median $660.69 Typical High $794.33 | Professional | None | $512.86 | $660.69 | $794.33 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $1,348.96 | Professional | None | $363.08 | $645.65 | $1,348.96 |
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 $269.15 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $269.15 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $107.15 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $371.54 | $524.81 | $524.81 |
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· 13th of 51
$741
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.