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 $467.74 Median $3,235.94 Typical High $3,235.94 | Professional | None | $467.74 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $15,848.93 Typical High $18,620.87 | Facility | None | $1,122.02 | $15,848.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $691.83 | Professional | None | $436.52 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $323.59 Typical High $416.87 | Professional | 62 · Two surgeons | $275.42 | $323.59 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | 80 · Assistant surgeon | $70.79 | $83.18 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $93.33 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $93.33 |
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 $446.68 Median $724.44 Typical High $1,122.02 | Professional | None | $446.68 | $724.44 | $1,122.02 |
ConnectiCare Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $371.54 Median $616.60 Typical High $1,148.15 | Professional | None | $371.54 | $616.60 | $1,148.15 |
3 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 54 · Surgery only Typical Low $346.74 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $346.74 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $70.79 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $46.77 | $323.59 | $323.59 |
Where Connecticut sits
The same service costs 7.1 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· 33rd of 51
$631
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.