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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $467.74 | Professional | None | $288.40 | $416.87 | $467.74 |
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 $281.84 Median $512.86 Typical High $691.83 | Professional | None | $281.84 | $512.86 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $776.25 Typical High $1,023.29 | Professional | 50 · Both sides | $426.58 | $776.25 | $1,023.29 |
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 $346.74 Median $446.68 Typical High $741.31 | Professional | None | $346.74 | $446.68 | $741.31 |
ConnectiCare Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $549.54 | Professional | None | $416.87 | $436.52 | $549.54 |
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 $218.78 Median $426.58 Typical High $851.14 | Professional | None | $218.78 | $426.58 | $851.14 |
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 $151.36 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $223.87 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $45.71 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $208.93 | $288.40 | $316.23 |
Where Connecticut sits
The same service costs 5.5 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· 13th of 51
$468
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.