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 $257.04 Median $380.19 Typical High $416.87 | Professional | None | $257.04 | $380.19 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,819.70 | $3,162.28 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $630.96 | Professional | None | $269.15 | $478.63 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $707.95 Typical High $954.99 | Professional | 50 · Both sides | $398.11 | $707.95 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $288.40 Typical High $371.54 | Facility | None | $51.29 | $288.40 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $676.08 | Professional | None | $302.00 | $407.38 | $676.08 |
ConnectiCare Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $512.86 | Professional | None | $380.19 | $416.87 | $512.86 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $204.17 Median $398.11 Typical High $776.25 | Professional | None | $204.17 | $398.11 | $776.25 |
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 $138.04 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $138.04 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $54.95 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $309.03 | Professional | 54 · Surgery only | $208.93 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $61.66 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $27.54 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $194.98 | $263.03 | $288.40 |
Where Connecticut sits
The same service costs 5.4 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· 14th of 51
$417
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.