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 $218.78 Median $229.09 Typical High $269.15 | Professional | None | $218.78 | $229.09 | $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 $194.98 Median $354.81 Typical High $467.74 | Professional | None | $194.98 | $354.81 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $537.03 Typical High $691.83 | Professional | 50 · Both sides | $295.12 | $537.03 | $691.83 |
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 $239.88 Median $281.84 Typical High $524.81 | Professional | None | $239.88 | $281.84 | $524.81 |
ConnectiCare Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $416.87 | Professional | None | $234.42 | $275.42 | $416.87 |
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 $154.88 Median $302.00 Typical High $616.60 | Professional | None | $154.88 | $302.00 | $616.60 |
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 $107.15 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $107.15 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $42.66 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $158.49 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.38 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $147.91 | $158.49 | $190.55 |
Where Connecticut sits
The same service costs 5.0 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· 15th of 51
$302
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.