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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $912.01 | Professional | None | $602.56 | $912.01 | $912.01 |
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 $512.86 Median $870.96 Typical High $1,288.25 | Professional | None | $512.86 | $870.96 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $549.54 Typical High $812.83 | Professional | 62 · Two surgeons | $323.59 | $549.54 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $141.25 Typical High $204.17 | Professional | 80 · Assistant surgeon | $81.28 | $141.25 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $123.03 Typical High $177.83 | Professional | AS · PA/NP assist | $70.79 | $123.03 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $3,548.13 | Facility | None | $549.54 | $741.31 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,621.81 | Professional | None | $912.01 | $1,000.00 | $1,621.81 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,096.48 | Professional | None | $602.56 | $870.96 | $1,096.48 |
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 $467.74 Median $851.14 Typical High $1,778.28 | Professional | None | $467.74 | $851.14 | $1,778.28 |
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 $323.59 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $323.59 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $131.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $489.78 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $97.72 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $64.57 | $91.20 | $91.20 |
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· 17th of 51
$891
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.