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 $1,122.02 Median $1,122.02 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,122.02 | $2,754.23 |
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 $2,691.53 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,691.53 | $3,467.37 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $549.54 Typical High $660.69 | Professional | 80 · Assistant surgeon | $436.52 | $549.54 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $478.63 Typical High $575.44 | Professional | AS · PA/NP assist | $380.19 | $478.63 | $575.44 |
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 $2,344.23 Median $4,073.80 Typical High $6,165.95 | Professional | None | $2,344.23 | $4,073.80 | $6,165.95 |
ConnectiCare Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
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 $1,995.26 Median $5,623.41 Typical High $10,471.29 | Professional | None | $1,995.26 | $5,623.41 | $10,471.29 |
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 $562.34 Median $562.34 Typical High $1,380.38 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $549.54 | Professional | 53 · Discontinued | $223.87 | $223.87 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $2,089.30 | Professional | 54 · Surgery only | $831.76 | $831.76 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $416.87 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $275.42 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $275.42 |
Where Connecticut sits
The same service costs 5.6 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· 18th of 51
$3,467
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.