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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $446.68 Typical High $933.25 | Professional | None | $162.18 | $446.68 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $27,542.29 Median $27,542.29 Typical High $37,153.52 | Facility | None | $27,542.29 | $27,542.29 | $37,153.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $575.44 Typical High $1,380.38 | Professional | None | $218.78 | $575.44 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $851.14 Typical High $1,949.84 | Professional | 50 · Both sides | $331.13 | $851.14 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $1,288.25 | Professional | None | $208.93 | $281.84 | $1,288.25 |
ConnectiCare Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,148.15 | Professional | None | $676.08 | $912.01 | $1,148.15 |
Health New England Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $851.14 | Professional | None | $134.90 | $134.90 | $851.14 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,890.45 | $7,079.46 |
United Setting Professional Modifier None Typical Low $154.88 Median $524.81 Typical High $1,659.59 | Professional | None | $154.88 | $524.81 | $1,659.59 |
5 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 $223.87 Typical High $457.09 | Professional | 52 · Reduced service | $85.11 | $223.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $89.13 Typical High $186.21 | Professional | 53 · Discontinued | $34.67 | $89.13 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $338.84 Typical High $691.83 | Professional | 54 · Surgery only | $128.82 | $338.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $67.61 Typical High $138.04 | Professional | 55 · Aftercare only | $25.70 | $67.61 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $44.67 Typical High $93.33 | Professional | 56 · Pre-op care only | $16.98 | $44.67 | $93.33 |
Where Connecticut sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 31st of 51
$525
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.