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 $218.78 Median $295.12 Typical High $549.54 | Professional | None | $218.78 | $295.12 | $549.54 |
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 $177.83 Median $218.78 Typical High $741.31 | Professional | None | $177.83 | $218.78 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $112.20 Median $138.04 Typical High $467.74 | Professional | 62 · Two surgeons | $112.20 | $138.04 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.18 Median $35.48 Typical High $117.49 | Professional | 80 · Assistant surgeon | $28.18 | $35.48 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $24.55 Median $30.90 Typical High $104.71 | Professional | AS · PA/NP assist | $24.55 | $30.90 | $104.71 |
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 $263.03 Median $457.09 Typical High $537.03 | Professional | None | $263.03 | $457.09 | $537.03 |
ConnectiCare Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $151.36 Median $245.47 Typical High $549.54 | Professional | None | $151.36 | $245.47 | $549.54 |
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 $158.49 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $32.36 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.38 | $29.51 | $29.51 |
Where Connecticut sits
The same service costs 10.5 times more in North Dakota 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· 33rd of 51
$295
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.