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 $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,737.80 Typical High $2,238.72 | Professional | None | $977.24 | $1,737.80 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,570.40 Typical High $3,311.31 | Professional | 50 · Both sides | $1,479.11 | $2,570.40 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $3,467.37 | Facility | None | $851.14 | $2,630.27 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,454.71 | Professional | None | $912.01 | $1,318.26 | $2,454.71 |
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 $676.08 Median $1,122.02 Typical High $1,698.24 | Professional | None | $676.08 | $1,122.02 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $3,548.13 | Professional | None | $954.99 | $1,288.25 | $3,548.13 |
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 $630.96 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $251.19 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $1,174.90 | $1,174.90 |
Where Connecticut sits
The same service costs 7.6 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· 15th of 51
$1,698
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.