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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | None | $549.54 | $616.60 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $7,079.46 | Professional | None | $691.83 | $812.83 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,232.93 Typical High $12,589.25 | Facility | None | $851.14 | $10,232.93 | $12,589.25 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $389.05 Median $776.25 Typical High $1,348.96 | Professional | None | $389.05 | $776.25 | $1,348.96 |
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 $275.42 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $61.66 |
Where Connecticut sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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· 23rd of 51
$813
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.