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 $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $776.25 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,905.46 | Professional | None | $676.08 | $933.25 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,412.54 Typical High $2,884.03 | Professional | 50 · Both sides | $1,023.29 | $1,412.54 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $3,388.44 | Facility | None | $851.14 | $2,630.27 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,698.24 | Professional | None | $954.99 | $1,023.29 | $1,698.24 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,071.52 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,778.28 | Professional | None | $724.44 | $1,096.48 | $1,778.28 |
6 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 $389.05 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $389.05 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $154.88 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $575.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $114.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $77.62 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $537.03 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 7.6 times more in Alaska than in Texas. 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· 28th of 51
$1,047
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.