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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $2,951.21 Typical High $2,951.21 | Professional | None | $1,737.80 | $2,951.21 | $2,951.21 |
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 $1,698.24 Median $2,691.53 Typical High $3,981.07 | Professional | None | $1,698.24 | $2,691.53 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,981.07 Typical High $6,025.60 | Professional | 50 · Both sides | $2,454.71 | $3,981.07 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $426.58 Typical High $630.96 | Professional | 80 · Assistant surgeon | $263.03 | $426.58 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $371.54 Typical High $562.34 | Professional | AS · PA/NP assist | $229.09 | $371.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,511.89 | $3,090.30 | $4,365.16 |
ConnectiCare Setting Professional Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,235.94 | $3,311.31 | $3,311.31 |
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 $1,659.59 Median $2,570.40 Typical High $5,248.07 | Professional | None | $1,659.59 | $2,570.40 | $5,248.07 |
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 $870.96 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $870.96 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $354.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,318.26 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $263.03 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $173.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,230.27 | $2,089.30 | $2,089.30 |
Where Connecticut sits
The same service costs 6.9 times more in Alaska than in Texas. 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· 14th 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.