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 $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
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 $70.79 Median $95.50 Typical High $257.04 | Professional | None | $70.79 | $95.50 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $5,370.32 | Facility | None | $851.14 | $4,265.80 | $5,370.32 |
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 $524.81 Median $912.01 Typical High $1,995.26 | Professional | None | $524.81 | $912.01 | $1,995.26 |
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 $281.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $70.79 | $70.79 |
Where Connecticut sits
The same service costs 10.2 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
$525
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.