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 $7,585.78 Typical High $9,772.37 | Facility | None | $4,365.16 | $7,585.78 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $1,000.00 Typical High $1,000.00 | Professional | None | $457.09 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $11,748.98 Typical High $14,125.38 | Facility | None | $4,073.80 | $11,748.98 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $1,380.38 | Professional | None | $380.19 | $645.65 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $954.99 Typical High $2,041.74 | Professional | 50 · Both sides | $562.34 | $954.99 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $407.38 Typical High $870.96 | Professional | 62 · Two surgeons | $234.42 | $407.38 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $102.33 Typical High $218.78 | Professional | 80 · Assistant surgeon | $60.26 | $102.33 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $89.13 Typical High $190.55 | Professional | AS · PA/NP assist | $52.48 | $89.13 | $190.55 |
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 $575.44 Median $933.25 Typical High $1,230.27 | Professional | None | $575.44 | $933.25 | $1,230.27 |
ConnectiCare Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,023.29 | Professional | None | $707.95 | $707.95 | $1,023.29 |
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 $426.58 Median $776.25 Typical High $1,380.38 | Professional | None | $426.58 | $776.25 | $1,380.38 |
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 $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $229.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $91.20 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $338.84 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $69.18 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $45.71 | $100.00 | $100.00 |
Where Connecticut sits
The same service costs 3.7 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· 12th of 51
$871
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.