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 $398.11 Median $549.54 Typical High $660.69 | Professional | None | $398.11 | $549.54 | $660.69 |
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 $331.13 Median $616.60 Typical High $776.25 | Professional | None | $331.13 | $616.60 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $912.01 Typical High $1,174.90 | Professional | 50 · Both sides | $501.19 | $912.01 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $1,380.38 | Facility | None | $512.86 | $691.83 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $954.99 | Professional | None | $302.00 | $457.09 | $954.99 |
ConnectiCare Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $660.69 | Professional | None | $331.13 | $537.03 | $660.69 |
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 $331.13 Median $467.74 Typical High $1,318.26 | Professional | None | $331.13 | $467.74 | $1,318.26 |
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 $218.78 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $218.78 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $89.13 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $331.13 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $66.07 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $309.03 | $389.05 | $446.68 |
Where Connecticut sits
The same service costs 5.0 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· 16th of 51
$550
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.