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 $645.65 Median $1,071.52 Typical High $1,071.52 | Professional | None | $645.65 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,659.59 | Professional | None | $676.08 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,778.28 Typical High $2,398.83 | Professional | 50 · Both sides | $977.24 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $426.58 | $741.31 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $5,370.32 | Facility | None | $851.14 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,698.24 | Professional | None | $933.25 | $1,047.13 | $1,698.24 |
ConnectiCare Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,096.48 | Professional | None | $812.83 | $1,047.13 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,905.46 | Professional | None | $562.34 | $1,047.13 | $1,905.46 |
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 $346.74 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $346.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $141.25 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $524.81 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $104.71 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $70.79 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $758.58 |
Where Connecticut sits
The same service costs 7.6 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· 13th of 51
$1,175
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.