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 $269.15 Typical High $407.38 | Professional | None | $257.04 | $269.15 | $407.38 |
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 $223.87 Median $309.03 Typical High $416.87 | Professional | None | $223.87 | $309.03 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $467.74 Typical High $616.60 | Professional | 50 · Both sides | $331.13 | $467.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $1,905.46 | Facility | None | $549.54 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $588.84 | Professional | None | $245.47 | $346.74 | $588.84 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $478.63 | Professional | None | $331.13 | $389.05 | $478.63 |
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 $158.49 Median $323.59 Typical High $741.31 | Professional | None | $158.49 | $323.59 | $741.31 |
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 $128.82 Median $134.90 Typical High $204.17 | Professional | 52 · Reduced service | $128.82 | $134.90 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $81.28 | Professional | 53 · Discontinued | $51.29 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $309.03 | Professional | 54 · Surgery only | $190.55 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $288.40 |
Where Connecticut sits
The same service costs 4.1 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· 18th of 51
$316
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.