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 $416.87 Median $630.96 Typical High $630.96 | Professional | None | $416.87 | $630.96 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $7,943.28 | Facility | None | $4,786.30 | $5,888.44 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $724.44 | Professional | None | $316.23 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $83.18 Typical High $114.82 | Professional | 80 · Assistant surgeon | $50.12 | $83.18 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $72.44 Typical High $100.00 | Professional | AS · PA/NP assist | $43.65 | $72.44 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $2,691.53 | Facility | None | $426.58 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,000.00 | Professional | None | $562.34 | $616.60 | $1,000.00 |
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 $371.54 Median $512.86 Typical High $616.60 | Professional | None | $371.54 | $512.86 | $616.60 |
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 $288.40 Median $524.81 Typical High $1,096.48 | Professional | None | $288.40 | $524.81 | $1,096.48 |
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 $208.93 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $61.66 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $63.10 | $63.10 |
Where Connecticut sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 16th of 51
$550
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.