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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $15,848.93 Typical High $18,620.87 | Facility | None | $1,122.02 | $15,848.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $3,548.13 Typical High $10,471.29 | Professional | None | $1,698.24 | $3,548.13 | $10,471.29 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $15,488.17 Typical High $19,054.61 | Facility | None | $851.14 | $15,488.17 | $19,054.61 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,290.87 Typical High $5,011.87 | Professional | None | $1,548.82 | $2,290.87 | $5,011.87 |
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 $812.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $812.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $162.18 | $190.55 | $190.55 |
Where Connecticut sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 13th of 51
$3,162
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.