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 $245.47 Median $251.19 Typical High $389.05 | Professional | None | $245.47 | $251.19 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $389.05 | Professional | None | $208.93 | $295.12 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $436.52 Typical High $588.84 | Professional | 50 · Both sides | $316.23 | $436.52 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $1,000.00 | Facility | None | $363.08 | $426.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $562.34 | Professional | None | $223.87 | $309.03 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $457.09 | Professional | None | $323.59 | $371.54 | $457.09 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $691.83 | Professional | None | $144.54 | $302.00 | $691.83 |
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 $123.03 Median $125.89 Typical High $194.98 | Professional | 52 · Reduced service | $123.03 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $77.62 | Professional | 53 · Discontinued | $48.98 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $190.55 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $190.55 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $38.90 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $177.83 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $169.82 | $177.83 | $269.15 |
Where Connecticut sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 16th of 51
$302
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.