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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $891.25 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
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 $1,047.13 Median $1,995.26 Typical High $2,454.71 | Professional | 50 · Both sides | $1,047.13 | $1,995.26 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,548.13 Typical High $4,466.84 | Facility | None | $741.31 | $3,548.13 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,949.84 | Professional | None | $645.65 | $1,000.00 | $1,949.84 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,288.25 | Professional | None | $575.44 | $933.25 | $1,288.25 |
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 $707.95 Median $977.24 Typical High $2,630.27 | Professional | None | $707.95 | $977.24 | $2,630.27 |
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 $177.83 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $660.69 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $131.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $616.60 | $831.76 | $831.76 |
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
$1,349
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.