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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,023.29 | Professional | None | $660.69 | $1,000.00 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $17,378.01 Typical High $25,703.96 | Facility | None | $3,715.35 | $17,378.01 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,174.90 Typical High $1,621.81 | Professional | None | $616.60 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,737.80 Typical High $2,454.71 | Professional | 50 · Both sides | $912.01 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $380.19 | $724.44 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,548.82 | Professional | None | $954.99 | $1,047.13 | $1,548.82 |
ConnectiCare Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,071.52 | Professional | None | $741.31 | $1,000.00 | $1,071.52 |
Health New England Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $18,197.01 | Professional | None | $5,623.41 | $5,623.41 | $18,197.01 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $1,778.28 | Professional | None | $512.86 | $954.99 | $1,778.28 |
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 $338.84 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $512.86 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $102.33 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $67.61 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $478.63 | $691.83 | $691.83 |
Where Connecticut sits
The same service costs 8.1 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· 14th of 51
$1,096
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.