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 $4,570.88 Median $6,760.83 Typical High $11,481.54 | Facility | None | $4,570.88 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $1,148.15 | Professional | None | $371.54 | $524.81 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $5,754.40 | Facility | None | $851.14 | $4,365.16 | $5,754.40 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $11,481.54 | Facility | None | $870.96 | $5,495.41 | $11,481.54 |
United Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,819.70 | Professional | None | $549.54 | $954.99 | $1,819.70 |
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 $288.40 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $64.57 |
Where Connecticut sits
The same service costs 10.2 times more in Texas than in New York. 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· 46th of 51
$741
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.