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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $204.17 | Professional | None | $177.83 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $630.96 | Professional | None | $371.54 | $501.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $1,548.82 | Facility | None | $512.86 | $933.25 | $1,548.82 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $616.60 | Professional | None | $181.97 | $323.59 | $616.60 |
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 $95.50 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $20.42 |
Where Connecticut sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 21st of 51
$447
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.