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 $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,511.89 | $2,511.89 |
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 $229.09 Median $933.25 Typical High $2,630.27 | Professional | None | $229.09 | $933.25 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,466.84 Typical High $5,495.41 | Facility | None | $851.14 | $4,466.84 | $5,495.41 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $6,606.93 | Professional | None | $1,995.26 | $3,235.94 | $6,606.93 |
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 $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,023.29 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,548.82 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $208.93 | $251.19 | $251.19 |
Where Connecticut sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 37th of 51
$2,089
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.