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 $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $12,022.64 Typical High $14,125.38 | Facility | None | $2,884.03 | $12,022.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,318.26 | $2,290.87 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $371.54 Typical High $489.78 | Professional | 80 · Assistant surgeon | $208.93 | $371.54 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $323.59 Typical High $436.52 | Professional | AS · PA/NP assist | $181.97 | $323.59 | $436.52 |
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 $50.12 Median $60.26 Typical High $61.66 | Professional | None | $50.12 | $60.26 | $61.66 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
Where Connecticut sits
The same service costs 257.0 times more in Wisconsin 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· 42nd 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.