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 $234.42 Median $630.96 Typical High $630.96 | Professional | None | $234.42 | $630.96 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $1,905.46 | Professional | None | $194.98 | $257.04 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $162.18 Typical High $1,202.26 | Professional | 62 · Two surgeons | $123.03 | $162.18 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $40.74 Typical High $309.03 | Professional | 80 · Assistant surgeon | $30.90 | $40.74 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $35.48 Typical High $269.15 | Professional | AS · PA/NP assist | $26.92 | $35.48 | $269.15 |
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 $208.93 Median $426.58 Typical High $741.31 | Professional | None | $208.93 | $426.58 | $741.31 |
ConnectiCare Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $524.81 | Professional | None | $218.78 | $338.84 | $524.81 |
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 $165.96 Median $302.00 Typical High $645.65 | Professional | None | $165.96 | $302.00 | $645.65 |
3 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 54 · Surgery only Typical Low $177.83 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $177.83 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $35.48 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $23.44 | $63.10 | $63.10 |
Where Connecticut sits
The same service costs 8.1 times more in New York than in Missouri. 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· 38th of 51
$275
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.