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 $190.55 Median $275.42 Typical High $275.42 | Professional | None | $190.55 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $407.38 | Professional | None | $169.82 | $275.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,011.87 Typical High $6,760.83 | Facility | None | $851.14 | $5,011.87 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $478.63 | Professional | None | $269.15 | $309.03 | $478.63 |
ConnectiCare Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | None | $288.40 | $288.40 | $316.23 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $537.03 | Professional | None | $186.21 | $281.84 | $537.03 |
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 $100.00 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $100.00 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $39.81 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $151.36 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $27.54 |
Where Connecticut sits
The same service costs 10.2 times more in Oklahoma than in Kentucky. 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· 25th of 51
$302
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.