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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,348.96 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $4,677.35 | Professional | None | $1,778.28 | $2,187.76 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $354.81 Typical High $741.31 | Professional | 80 · Assistant surgeon | $288.40 | $354.81 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $309.03 Typical High $660.69 | Professional | AS · PA/NP assist | $251.19 | $309.03 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $9,549.93 Typical High $12,022.64 | Facility | None | $851.14 | $9,549.93 | $12,022.64 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,862.09 Typical High $3,311.31 | Professional | None | $977.24 | $1,862.09 | $3,311.31 |
5 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 $676.08 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $151.36 |
Where Connecticut sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 15th of 51
$2,138
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.