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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $354.81 | Professional | None | $89.13 | $104.71 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $3,630.78 Typical High $4,466.84 | Facility | None | $3,162.28 | $3,630.78 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $194.98 Typical High $371.54 | Professional | None | $63.10 | $194.98 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $4,265.80 | Facility | None | $501.19 | $1,000.00 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $371.54 Typical High $524.81 | Professional | None | $131.83 | $371.54 | $524.81 |
ConnectiCare Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $549.54 | Professional | None | $77.62 | $190.55 | $549.54 |
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 $44.67 Median $51.29 Typical High $177.83 | Professional | 52 · Reduced service | $44.67 | $51.29 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $72.44 | Professional | 53 · Discontinued | $17.78 | $20.89 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $77.62 Typical High $269.15 | Professional | 54 · Surgery only | $67.61 | $77.62 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $53.70 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $35.48 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $35.48 |
Where Connecticut sits
The same service costs 4.5 times more in Oklahoma 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· 33rd of 51
$229
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.