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 $239.88 Median $346.74 Typical High $426.58 | Professional | None | $239.88 | $346.74 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $489.78 | Professional | None | $204.17 | $371.54 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $562.34 Typical High $724.44 | Professional | 50 · Both sides | $309.03 | $562.34 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $1,000.00 | Facility | None | $269.15 | $316.23 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $537.03 | Professional | None | $190.55 | $295.12 | $537.03 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $416.87 | Professional | None | $186.21 | $316.23 | $416.87 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $776.25 | Professional | None | $208.93 | $295.12 | $776.25 |
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 $138.04 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $138.04 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $54.95 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $275.42 |
Where Connecticut sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 12th of 51
$347
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.