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 $630.96 Median $851.14 Typical High $851.14 | Professional | None | $630.96 | $851.14 | $851.14 |
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 $512.86 Median $912.01 Typical High $1,122.02 | Professional | None | $512.86 | $912.01 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,318.26 Typical High $1,659.59 | Professional | 50 · Both sides | $741.31 | $1,318.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $549.54 Typical High $707.95 | Professional | 62 · Two surgeons | $316.23 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,570.40 Typical High $3,235.94 | Facility | None | $549.54 | $2,570.40 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,258.93 | Professional | None | $467.74 | $676.08 | $1,258.93 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $870.96 | Professional | None | $363.08 | $602.56 | $870.96 |
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 $478.63 Median $660.69 Typical High $1,778.28 | Professional | None | $478.63 | $660.69 | $1,778.28 |
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 $316.23 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $478.63 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $95.50 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $446.68 | $602.56 | $602.56 |
Where Connecticut sits
The same service costs 8.3 times more in Wyoming than in Texas. 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
$851
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.