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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $512.86 | Professional | None | $426.58 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $912.01 | Professional | None | $281.84 | $380.19 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $15,848.93 Typical High $19,952.62 | Facility | None | $851.14 | $15,848.93 | $19,952.62 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $18,197.01 | Facility | None | $1,348.96 | $9,549.93 | $18,197.01 |
United Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,412.54 | Professional | None | $416.87 | $676.08 | $1,412.54 |
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 $213.80 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $51.29 | $51.29 |
Where Connecticut sits
The same service costs 32.4 times more in Oklahoma 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· 46th of 51
$562
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.