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 $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | None | $302.00 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $13,182.57 Typical High $16,218.10 | Facility | None | $977.24 | $13,182.57 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $794.33 | Professional | None | $275.42 | $478.63 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $295.12 Typical High $501.19 | Professional | 62 · Two surgeons | $173.78 | $295.12 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $74.13 Typical High $125.89 | Professional | 80 · Assistant surgeon | $43.65 | $74.13 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $66.07 Typical High $112.20 | Professional | AS · PA/NP assist | $38.90 | $66.07 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,570.88 Typical High $5,888.44 | Facility | None | $851.14 | $4,570.88 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $758.58 | Professional | None | $426.58 | $616.60 | $758.58 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $3,801.89 | Facility | None | $512.86 | $707.95 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | None | $549.54 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $954.99 | Professional | None | $331.13 | $524.81 | $954.99 |
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 $158.49 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $64.57 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $47.86 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $31.62 | $45.71 | $45.71 |
Where Connecticut sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 32nd of 51
$513
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.