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 $457.09 Median $549.54 Typical High $549.54 | Professional | None | $457.09 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $812.83 | Professional | None | $302.00 | $416.87 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,398.83 Typical High $4,265.80 | Facility | None | $851.14 | $2,398.83 | $4,265.80 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,513.56 | Professional | None | $426.58 | $724.44 | $1,513.56 |
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 $229.09 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $45.71 | $54.95 | $54.95 |
Where Connecticut sits
The same service costs 8.1 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· 48th of 51
$550
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.