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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $1,348.96 | Professional | None | $512.86 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,445.44 Typical High $2,041.74 | Professional | 50 · Both sides | $758.58 | $1,445.44 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $602.56 Typical High $851.14 | Professional | 62 · Two surgeons | $316.23 | $602.56 | $851.14 |
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 $1,445.44 | Professional | None | $870.96 | $1,000.00 | $1,445.44 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,047.13 | $1,071.52 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,995.26 | Professional | None | $602.56 | $1,000.00 | $1,995.26 |
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 $323.59 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $323.59 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $128.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $478.63 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $95.50 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $64.57 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $446.68 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 5.9 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· 22nd of 51
$1,096
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.