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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $1,778.28 Typical High $3,311.31 | Professional | None | $162.18 | $1,778.28 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $20,892.96 Median $25,118.86 Typical High $36,307.81 | Facility | None | $20,892.96 | $25,118.86 | $36,307.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $1,513.56 Typical High $4,073.80 | Professional | None | $199.53 | $1,513.56 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $32.36 Median $213.80 Typical High $645.65 | Professional | 80 · Assistant surgeon | $32.36 | $213.80 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $28.18 Median $186.21 Typical High $575.44 | Professional | AS · PA/NP assist | $28.18 | $186.21 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $4,265.80 | Facility | None | $501.19 | $851.14 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $416.87 Typical High $3,981.07 | Professional | None | $208.93 | $416.87 | $3,981.07 |
ConnectiCare Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,388.44 | Professional | None | $3,311.31 | $3,311.31 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $177.83 Median $870.96 Typical High $4,168.69 | Professional | None | $177.83 | $870.96 | $4,168.69 |
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 $114.82 Median $134.90 Typical High $1,659.59 | Professional | 52 · Reduced service | $114.82 | $134.90 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $53.70 Typical High $660.69 | Professional | 53 · Discontinued | $45.71 | $53.70 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $199.53 Typical High $2,511.89 | Professional | 54 · Surgery only | $169.82 | $199.53 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $39.81 Typical High $501.19 | Professional | 55 · Aftercare only | $34.67 | $39.81 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.92 Typical High $331.13 | Professional | 56 · Pre-op care only | $22.91 | $26.92 | $331.13 |
Where Connecticut sits
The same service costs 11.2 times more in Oklahoma than in Hawaii. 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· 23rd of 51
$1,862
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.