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 Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,238.72 | $3,162.28 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $3,019.95 Typical High $4,466.84 | Professional | None | $2,089.30 | $3,019.95 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $4,466.84 Typical High $6,760.83 | Professional | 50 · Both sides | $3,162.28 | $4,466.84 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,041.74 Typical High $2,691.53 | Facility | None | $851.14 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $3,890.45 Typical High $4,897.79 | Professional | None | $3,019.95 | $3,890.45 | $4,897.79 |
ConnectiCare Setting Professional Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $4,265.80 | Professional | None | $2,570.40 | $3,548.13 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $3,090.30 Typical High $5,623.41 | Professional | None | $1,584.89 | $3,090.30 | $5,623.41 |
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 $1,122.02 Median $1,584.89 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,122.02 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $630.96 Typical High $758.58 | Professional | 53 · Discontinued | $446.68 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $478.63 Typical High $562.34 | Professional | 55 · Aftercare only | $331.13 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $316.23 Typical High $380.19 | Professional | 56 · Pre-op care only | $223.87 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,238.72 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,238.72 | $2,630.27 |
Where Connecticut sits
The same service costs 5.5 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· 12th 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.