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 $691.83 Median $912.01 Typical High $912.01 | Professional | None | $691.83 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $1,023.29 Typical High $1,348.96 | Professional | None | $575.44 | $1,023.29 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,513.56 Typical High $2,041.74 | Professional | 50 · Both sides | $851.14 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $162.18 Typical High $218.78 | Professional | 80 · Assistant surgeon | $91.20 | $162.18 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $79.43 | $141.25 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,570.40 Typical High $3,311.31 | Facility | None | $851.14 | $2,570.40 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,698.24 | Professional | None | $891.25 | $933.25 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,023.29 | Professional | None | $741.31 | $831.76 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $1,905.46 | Professional | None | $501.19 | $870.96 | $1,905.46 |
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 $346.74 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $645.65 | $645.65 |
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· 22nd of 51
$912
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.