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 $851.14 Median $1,513.56 Typical High $1,513.56 | Professional | None | $851.14 | $1,513.56 | $1,513.56 |
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 $776.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $776.25 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $794.33 Typical High $1,174.90 | Professional | 62 · Two surgeons | $478.63 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $6,918.31 | Facility | None | $851.14 | $5,623.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,288.25 | $2,137.96 |
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 $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,318.26 | $1,513.56 |
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 $812.83 Median $1,122.02 Typical High $2,691.53 | Professional | None | $812.83 | $1,122.02 | $2,691.53 |
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 $478.63 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $707.95 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $660.69 | $1,047.13 | $1,047.13 |
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· 17th of 51
$1,514
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.