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 Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $69.18 | Professional | None | $50.12 | $69.18 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $83.18 | Professional | None | $41.69 | $64.57 | $83.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $97.72 Typical High $114.82 | Professional | 50 · Both sides | $60.26 | $97.72 | $114.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $25.12 Median $40.74 Typical High $47.86 | Professional | 62 · Two surgeons | $25.12 | $40.74 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $758.58 Typical High $1,659.59 | Facility | None | $426.58 | $758.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $123.03 | Professional | None | $72.44 | $97.72 | $123.03 |
ConnectiCare Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $131.83 | Professional | None | $44.67 | $67.61 | $131.83 |
4 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 $25.12 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $25.12 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $10.00 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $7.59 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.01 | $6.92 | $6.92 |
Where Connecticut sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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· 34th of 51
$69.18
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.