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 $467.74 Median $467.74 Typical High $724.44 | Professional | None | $467.74 | $467.74 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $645.65 | Professional | None | $371.54 | $512.86 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $741.31 Typical High $977.24 | Professional | 50 · Both sides | $562.34 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $309.03 Typical High $407.38 | Professional | 62 · Two surgeons | $234.42 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $3,801.89 | Facility | None | $1,000.00 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $912.01 | Professional | None | $257.04 | $489.78 | $912.01 |
ConnectiCare Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $794.33 | Professional | None | $338.84 | $562.34 | $794.33 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $1,445.44 | Professional | None | $309.03 | $512.86 | $1,445.44 |
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 $234.42 Median $234.42 Typical High $363.08 | Professional | 52 · Reduced service | $234.42 | $234.42 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | 53 · Discontinued | $93.33 | $93.33 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $549.54 | Professional | 54 · Surgery only | $346.74 | $346.74 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $109.65 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $512.86 |
Where Connecticut sits
The same service costs 5.5 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· 18th of 51
$537
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.