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 $6,760.83 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,760.83 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,659.59 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $16,595.87 Typical High $25,703.96 | Facility | None | $7,079.46 | $16,595.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $3,467.37 | Professional | None | $1,318.26 | $2,630.27 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $3,890.45 Typical High $5,248.07 | Professional | 50 · Both sides | $1,949.84 | $3,890.45 | $5,248.07 |
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 $2,454.71 Median $2,691.53 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,691.53 | $3,890.45 |
ConnectiCare Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,398.83 | $2,951.21 |
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 $1,318.26 Median $2,398.83 Typical High $4,466.84 | Professional | None | $1,318.26 | $2,398.83 | $4,466.84 |
4 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 54 · Surgery only Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,230.27 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $245.47 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $165.96 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,737.80 | $1,737.80 |
Where Connecticut sits
The same service costs 7.8 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· 20th of 51
$2,630
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.