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 $6,760.83 Typical High $12,589.25 | Facility | None | $4,570.88 | $6,760.83 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $660.69 | Professional | None | $457.09 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $26,915.35 Typical High $44,668.36 | Facility | None | $7,585.78 | $26,915.35 | $44,668.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $794.33 | Professional | None | $389.05 | $660.69 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $107.15 Typical High $125.89 | Professional | 80 · Assistant surgeon | $63.10 | $107.15 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $93.33 Typical High $109.65 | Professional | AS · PA/NP assist | $54.95 | $93.33 | $109.65 |
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 $501.19 Median $676.08 Typical High $1,071.52 | Professional | None | $501.19 | $676.08 | $1,071.52 |
ConnectiCare Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $446.68 Median $724.44 Typical High $1,445.44 | Professional | None | $446.68 | $724.44 | $1,445.44 |
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 $229.09 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $229.09 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $346.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $45.71 | $66.07 | $66.07 |
Where Connecticut sits
The same service costs 4.5 times more in Wisconsin 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· 19th of 51
$692
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.