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 $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | None | $416.87 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $30,902.95 Typical High $36,307.81 | Facility | None | $2,137.96 | $30,902.95 | $36,307.81 |
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 $38,904.51 Typical High $47,863.01 | Facility | None | $851.14 | $38,904.51 | $47,863.01 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,380.38 | Professional | None | $416.87 | $707.95 | $1,380.38 |
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 $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $50.12 |
Where Connecticut sits
The same service costs 57.5 times more in Arkansas 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· 48th of 51
$537
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.