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 $4,786.30 Median $7,585.78 Typical High $11,481.54 | Facility | None | $4,786.30 | $7,585.78 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $891.25 | Professional | None | $281.84 | $389.05 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $14,454.40 Typical High $18,197.01 | Facility | None | $851.14 | $14,454.40 | $18,197.01 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $18,197.01 | Facility | None | $1,348.96 | $9,549.93 | $18,197.01 |
United Setting Professional Modifier None Typical Low $53.70 Median $107.15 Typical High $524.81 | Professional | None | $53.70 | $107.15 | $524.81 |
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 $28.84 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 54 · Surgery only | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.17 |
Where Connecticut sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 38th of 51
$389
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.