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 $407.38 Median $741.31 Typical High $1,071.52 | Professional | None | $407.38 | $741.31 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,481.54 Typical High $13,489.63 | Facility | None | $2,754.23 | $11,481.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $1,174.90 | Professional | None | $371.54 | $645.65 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $954.99 Typical High $1,737.80 | Professional | 50 · Both sides | $562.34 | $954.99 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $398.11 Typical High $741.31 | Professional | 62 · Two surgeons | $234.42 | $398.11 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $524.81 Typical High $1,445.44 | Facility | None | $446.68 | $524.81 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,122.02 | Professional | None | $436.52 | $707.95 | $1,122.02 |
ConnectiCare Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | None | $831.76 | $831.76 | $1,096.48 |
Health New England Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $338.84 Median $676.08 Typical High $1,698.24 | Professional | None | $338.84 | $676.08 | $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 $223.87 Median $371.54 Typical High $537.03 | Professional | 52 · Reduced service | $223.87 | $371.54 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $147.91 Typical High $213.80 | Professional | 53 · Discontinued | $89.13 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $549.54 Typical High $794.33 | Professional | 54 · Surgery only | $338.84 | $549.54 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $109.65 Typical High $158.49 | Professional | 55 · Aftercare only | $67.61 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $74.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $44.67 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $512.86 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $316.23 | $512.86 | $741.31 |
Where Connecticut sits
The same service costs 4.1 times more in Wisconsin 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· 9th of 51
$741
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.