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 $794.33 Median $1,230.27 Typical High $1,230.27 | Professional | None | $794.33 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $1,698.24 | Professional | None | $724.44 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $194.98 Typical High $275.42 | Professional | 80 · Assistant surgeon | $114.82 | $194.98 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $169.82 Typical High $239.88 | Professional | AS · PA/NP assist | $100.00 | $169.82 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $4,265.80 | Facility | None | $501.19 | $1,000.00 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $891.25 | $1,202.26 | $1,862.09 |
ConnectiCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,174.90 | $1,348.96 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $2,570.40 | Professional | None | $776.25 | $1,318.26 | $2,570.40 |
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 $398.11 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $398.11 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $158.49 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $588.84 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $117.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $79.43 | $123.03 | $123.03 |
Where Connecticut sits
The same service costs 3.8 times more in Wisconsin than in New York. 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
$1,230
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.