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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,318.26 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $12,022.64 Typical High $14,125.38 | Facility | None | $4,073.80 | $12,022.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,778.28 Typical High $2,344.23 | Professional | None | $537.03 | $1,778.28 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $1,122.02 Typical High $1,479.11 | Professional | 62 · Two surgeons | $338.84 | $1,122.02 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $3,715.35 Typical High $7,585.78 | Professional | None | $1,949.84 | $3,715.35 | $7,585.78 |
ConnectiCare Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,951.21 Typical High $6,918.31 | Professional | None | $2,041.74 | $2,951.21 | $6,918.31 |
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 $660.69 Median $660.69 Typical High $1,230.27 | Professional | 52 · Reduced service | $660.69 | $660.69 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $489.78 | Professional | 53 · Discontinued | $263.03 | $263.03 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,862.09 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $371.54 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $245.47 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,737.80 |
Where Connecticut sits
The same service costs 18.2 times more in Alaska than in New York. 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· 40th of 51
$2,089
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.