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 $1,096.48 Median $1,096.48 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,096.48 | $2,089.30 |
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 $2,089.30 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,454.71 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $489.78 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $426.58 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $426.58 |
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 $2,041.74 Median $3,311.31 Typical High $5,128.61 | Professional | None | $2,041.74 | $3,311.31 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
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 $1,819.70 Median $3,467.37 Typical High $6,309.57 | Professional | None | $1,819.70 | $3,467.37 | $6,309.57 |
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 $549.54 Median $549.54 Typical High $1,047.13 | Professional | 52 · Reduced service | $549.54 | $549.54 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $416.87 | Professional | 53 · Discontinued | $218.78 | $218.78 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,584.89 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $316.23 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $208.93 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $208.93 |
Where Connecticut sits
The same service costs 4.7 times more in Alaska than in South Carolina. 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
$2,692
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.