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 $616.60 Median $870.96 Typical High $870.96 | Professional | None | $616.60 | $870.96 | $870.96 |
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 $489.78 Median $891.25 Typical High $1,348.96 | Professional | None | $489.78 | $891.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $549.54 Typical High $851.14 | Professional | 62 · Two surgeons | $309.03 | $549.54 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,148.15 | Professional | None | $758.58 | $870.96 | $1,148.15 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $977.24 | Professional | None | $537.03 | $794.33 | $977.24 |
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 $398.11 Median $741.31 Typical High $1,479.11 | Professional | None | $398.11 | $741.31 | $1,479.11 |
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 $302.00 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $302.00 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $123.03 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $457.09 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $61.66 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $426.58 | $602.56 | $602.56 |
Where Connecticut sits
The same service costs 18.2 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· 15th of 51
$871
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.