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 $4,570.88 Median $7,585.78 Typical High $12,882.50 | Facility | None | $4,570.88 | $7,585.78 | $12,882.50 |
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 $2,630.27 Median $3,715.35 Typical High $5,495.41 | Facility | None | $2,630.27 | $3,715.35 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,380.38 | Professional | None | $660.69 | $812.83 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,230.27 Typical High $1,995.26 | Professional | 50 · Both sides | $1,000.00 | $1,230.27 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $4,786.30 | Facility | None | $1,412.54 | $2,630.27 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,819.70 | Professional | None | $645.65 | $954.99 | $1,819.70 |
ConnectiCare Setting Facility Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,584.89 | Facility | None | $977.24 | $1,288.25 | $1,584.89 |
ConnectiCare Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $977.24 | Professional | None | $446.68 | $660.69 | $977.24 |
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 $630.96 Median $851.14 Typical High $2,511.89 | Professional | None | $630.96 | $851.14 | $2,511.89 |
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 $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 $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 $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 4.6 times more in Alaska than in New York. 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· 38th of 51
$933
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.