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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $363.08 | Professional | None | $234.42 | $316.23 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $489.78 | Professional | None | $229.09 | $371.54 | $489.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $234.42 Typical High $309.03 | Professional | 62 · Two surgeons | $144.54 | $234.42 | $309.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $52.48 Typical High $79.43 | Professional | 80 · Assistant surgeon | $34.67 | $52.48 | $79.43 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $48.98 Typical High $67.61 | Professional | AS · PA/NP assist | $32.36 | $48.98 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $398.11 Typical High $1,000.00 | Facility | None | $331.13 | $398.11 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $562.34 | Professional | None | $316.23 | $398.11 | $562.34 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
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 $239.88 Median $354.81 Typical High $691.83 | Professional | None | $239.88 | $354.81 | $691.83 |
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 $114.82 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $173.78 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $34.67 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.44 | $31.62 | $36.31 |
Where Connecticut sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 11th of 51
$380
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.