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 $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | None | $870.96 | $1,258.93 | $1,258.93 |
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 $776.25 Median $1,047.13 Typical High $2,137.96 | Professional | None | $776.25 | $1,047.13 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $660.69 Typical High $1,348.96 | Professional | 62 · Two surgeons | $478.63 | $660.69 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,981.07 Typical High $5,248.07 | Facility | None | $1,000.00 | $3,981.07 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,174.90 | $1,905.46 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,174.90 | $1,174.90 |
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 $812.83 Median $1,230.27 Typical High $1,995.26 | Professional | None | $812.83 | $1,230.27 | $1,995.26 |
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 $436.52 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $436.52 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $645.65 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $128.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $87.10 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $602.56 | $891.25 | $891.25 |
Where Connecticut sits
The same service costs 8.3 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· 30th of 51
$1,175
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.