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 $524.81 Median $691.83 Typical High $691.83 | Professional | None | $524.81 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,148.15 | Professional | None | $489.78 | $776.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $123.03 Typical High $181.97 | Professional | 80 · Assistant surgeon | $79.43 | $123.03 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $107.15 Typical High $158.49 | Professional | AS · PA/NP assist | $69.18 | $107.15 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $1,000.00 | Facility | None | $331.13 | $389.05 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,148.15 | Professional | None | $616.60 | $776.25 | $1,148.15 |
ConnectiCare Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | None | $933.25 | $954.99 | $954.99 |
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 $489.78 Median $676.08 Typical High $1,230.27 | Professional | None | $489.78 | $676.08 | $1,230.27 |
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 $257.04 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $257.04 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $102.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $75.86 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $69.18 | $69.18 |
Where Connecticut sits
The same service costs 3.2 times more in Wisconsin than in Arkansas. 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· 15th of 51
$708
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.