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 $776.25 Median $1,071.52 Typical High $1,071.52 | Professional | None | $776.25 | $1,071.52 | $1,071.52 |
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 $588.84 Median $1,000.00 Typical High $1,479.11 | Professional | None | $588.84 | $1,000.00 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $630.96 Typical High $933.25 | Professional | 62 · Two surgeons | $371.54 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $93.33 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $83.18 | $141.25 | $208.93 |
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 $1,071.52 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,148.15 | $1,905.46 |
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 $691.83 Median $1,000.00 Typical High $1,258.93 | Professional | None | $691.83 | $1,000.00 | $1,258.93 |
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 $549.54 Median $1,000.00 Typical High $2,041.74 | Professional | None | $549.54 | $1,000.00 | $2,041.74 |
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 $389.05 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $575.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $107.15 |
Where Connecticut sits
The same service costs 4.7 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· 15th of 51
$1,023
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.