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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $457.09 | Professional | None | $199.53 | $309.03 | $457.09 |
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 $199.53 Median $275.42 Typical High $371.54 | Professional | None | $199.53 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $407.38 Typical High $537.03 | Professional | 50 · Both sides | $295.12 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $478.63 Typical High $1,000.00 | Facility | None | $407.38 | $478.63 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $316.23 Typical High $588.84 | Professional | None | $138.04 | $316.23 | $588.84 |
ConnectiCare Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $501.19 | Professional | None | $208.93 | $346.74 | $501.19 |
Health New England Setting Professional Modifier None Typical Low $114.82 Median $707.95 Typical High $707.95 | Professional | None | $114.82 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $870.96 | Professional | None | $165.96 | $302.00 | $870.96 |
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 $125.89 Median $125.89 Typical High $223.87 | Professional | 52 · Reduced service | $125.89 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $89.13 | Professional | 53 · Discontinued | $50.12 | $50.12 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $331.13 | Professional | 54 · Surgery only | $190.55 | $190.55 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $66.07 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $177.83 | $177.83 | $309.03 |
Where Connecticut sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 22nd of 51
$302
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.