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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $269.15 | Professional | None | $165.96 | $218.78 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $363.08 | Professional | None | $147.91 | $234.42 | $363.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $93.33 Median $144.54 Typical High $218.78 | Professional | 62 · Two surgeons | $93.33 | $144.54 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $1,000.00 | Facility | None | $181.97 | $208.93 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | None | $199.53 | $239.88 | $446.68 |
ConnectiCare Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $371.54 | Professional | None | $288.40 | $288.40 | $371.54 |
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 $147.91 Median $218.78 Typical High $416.87 | Professional | None | $147.91 | $218.78 | $416.87 |
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 $83.18 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $83.18 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $125.89 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.60 | $21.88 | $26.92 |
Where Connecticut sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 22nd of 51
$234
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.