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 $165.96 Median $223.87 Typical High $269.15 | Professional | None | $165.96 | $223.87 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $28,183.83 | Facility | None | $1,819.70 | $3,162.28 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $380.19 | Professional | None | $158.49 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $398.11 Typical High $575.44 | Professional | 50 · Both sides | $234.42 | $398.11 | $575.44 |
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 $218.78 Median $251.19 Typical High $416.87 | Professional | None | $218.78 | $251.19 | $416.87 |
ConnectiCare Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $316.23 | Professional | None | $234.42 | $251.19 | $316.23 |
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 $125.89 Median $239.88 Typical High $478.63 | Professional | None | $125.89 | $239.88 | $478.63 |
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 $85.11 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $44.67 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $128.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $120.23 | $158.49 | $186.21 |
Where Connecticut sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 11th of 51
$269
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.