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 $660.69 Median $954.99 Typical High $954.99 | Professional | None | $660.69 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $12,022.64 Typical High $16,982.44 | Facility | None | $6,456.54 | $12,022.64 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,548.82 | Professional | None | $588.84 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,698.24 Typical High $2,344.23 | Professional | 50 · Both sides | $870.96 | $1,698.24 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,513.56 | Professional | None | $870.96 | $1,000.00 | $1,513.56 |
ConnectiCare Setting Facility Modifier None Typical Low $676.08 Median $5,128.61 Typical High $5,248.07 | Facility | None | $676.08 | $5,128.61 | $5,248.07 |
ConnectiCare Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,096.48 | Professional | None | $616.60 | $912.01 | $1,096.48 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $10,000.00 | Facility | None | $870.96 | $5,495.41 | $10,000.00 |
United Setting Professional Modifier None Typical Low $501.19 Median $933.25 Typical High $1,698.24 | Professional | None | $501.19 | $933.25 | $1,698.24 |
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 $331.13 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 7.4 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· 16th of 51
$1,047
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.