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 $1,258.93 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,344.23 | Professional | None | $954.99 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $151.36 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $131.83 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,466.84 Typical High $5,495.41 | Facility | None | $741.31 | $4,466.84 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,778.28 | $3,019.95 |
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 $1,288.25 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,621.81 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,548.82 Typical High $3,311.31 | Professional | None | $870.96 | $1,548.82 | $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 $630.96 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $630.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $251.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $954.99 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $190.55 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $125.89 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $891.25 | $1,318.26 | $1,318.26 |
Where Connecticut sits
The same service costs 6.2 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· 16th of 51
$1,738
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.