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 $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | None | $870.96 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,348.96 Typical High $1,621.81 | Professional | None | $707.95 | $1,348.96 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,995.26 Typical High $2,398.83 | Professional | 50 · Both sides | $1,023.29 | $1,995.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $831.76 Typical High $1,023.29 | Professional | 62 · Two surgeons | $436.52 | $831.76 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,630.78 Typical High $4,466.84 | Facility | None | $851.14 | $3,630.78 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,905.46 | Professional | None | $645.65 | $1,000.00 | $1,905.46 |
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 $562.34 Median $933.25 Typical High $1,258.93 | Professional | None | $562.34 | $933.25 | $1,258.93 |
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 $691.83 Median $954.99 Typical High $2,570.40 | Professional | None | $691.83 | $954.99 | $2,570.40 |
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 $436.52 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $436.52 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $173.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $87.10 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $812.83 | $812.83 |
Where Connecticut sits
The same service costs 8.3 times more in Wyoming 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· 17th of 51
$1,318
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.