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 $181.97 Median $245.47 Typical High $380.19 | Professional | None | $181.97 | $245.47 | $380.19 |
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 $204.17 Median $288.40 Typical High $380.19 | Professional | None | $204.17 | $288.40 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $426.58 Typical High $575.44 | Professional | 50 · Both sides | $309.03 | $426.58 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $436.52 Typical High $1,000.00 | Facility | None | $371.54 | $436.52 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $549.54 | Professional | None | $229.09 | $309.03 | $549.54 |
ConnectiCare Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $446.68 | Professional | None | $316.23 | $371.54 | $446.68 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $676.08 | Professional | None | $141.25 | $295.12 | $676.08 |
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 $120.23 Median $123.03 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $123.03 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $181.97 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $269.15 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$295
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.