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 $2,754.23 Median $4,365.16 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $954.99 | Professional | None | $602.56 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,818.38 Typical High $7,585.78 | Facility | None | $831.76 | $2,818.38 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,174.90 | Professional | None | $489.78 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,174.90 Typical High $1,737.80 | Professional | 50 · Both sides | $724.44 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $1,174.90 | Facility | None | $478.63 | $707.95 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,318.26 | Professional | None | $724.44 | $831.76 | $1,318.26 |
ConnectiCare Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | None | $870.96 | $870.96 | $912.01 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,698.24 | Professional | None | $524.81 | $707.95 | $1,698.24 |
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 $302.00 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $302.00 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $120.23 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $457.09 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $60.26 | $95.50 | $95.50 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Utah. 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· 12th of 51
$912
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.