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 $295.12 Median $467.74 Typical High $467.74 | Professional | None | $295.12 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $16,595.87 Typical High $19,952.62 | Facility | None | $1,000.00 | $16,595.87 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $645.65 | Professional | None | $275.42 | $467.74 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $295.12 Typical High $416.87 | Professional | 62 · Two surgeons | $173.78 | $295.12 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $74.13 Typical High $104.71 | Professional | 80 · Assistant surgeon | $43.65 | $74.13 | $104.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $64.57 Typical High $91.20 | Professional | AS · PA/NP assist | $38.02 | $64.57 | $91.20 |
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 $331.13 Median $457.09 Typical High $724.44 | Professional | None | $331.13 | $457.09 | $724.44 |
ConnectiCare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | None | $467.74 | $467.74 | $512.86 |
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 $295.12 Median $457.09 Typical High $977.24 | Professional | None | $295.12 | $457.09 | $977.24 |
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 $151.36 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $61.66 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $229.09 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $45.71 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.90 | $46.77 | $46.77 |
Where Connecticut sits
The same service costs 3.9 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· 18th of 51
$501
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.