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 $3,467.37 Median $5,495.41 Typical High $5,495.41 | Professional | None | $3,467.37 | $5,495.41 | $5,495.41 |
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 $3,388.44 Median $5,754.40 Typical High $7,762.47 | Professional | None | $3,388.44 | $5,754.40 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $912.01 Typical High $1,258.93 | Professional | 80 · Assistant surgeon | $537.03 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $794.33 Typical High $1,096.48 | Professional | AS · PA/NP assist | $467.74 | $794.33 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $8,511.38 | Professional | None | $3,890.45 | $5,495.41 | $8,511.38 |
ConnectiCare Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,309.57 | Professional | None | $5,128.61 | $5,128.61 | $6,309.57 |
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 $3,548.13 Median $5,754.40 Typical High $11,481.54 | Professional | None | $3,548.13 | $5,754.40 | $11,481.54 |
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 $1,819.70 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $1,819.70 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $4,168.69 Typical High $4,168.69 | Professional | 54 · Surgery only | $2,754.23 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $831.76 Typical High $831.76 | Professional | 55 · Aftercare only | $549.54 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $363.08 | $549.54 | $549.54 |
Where Connecticut sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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· 11th of 51
$5,754
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.