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 $302.00 Median $316.23 Typical High $467.74 | Professional | None | $302.00 | $316.23 | $467.74 |
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 $245.47 Median $371.54 Typical High $575.44 | Professional | None | $245.47 | $371.54 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $549.54 Typical High $831.76 | Professional | 50 · Both sides | $363.08 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $562.34 Typical High $1,000.00 | Facility | None | $426.58 | $562.34 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $407.38 Typical High $707.95 | Professional | None | $173.78 | $407.38 | $707.95 |
ConnectiCare Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $602.56 | Professional | None | $234.42 | $398.11 | $602.56 |
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 $213.80 Median $371.54 Typical High $933.25 | Professional | None | $213.80 | $371.54 | $933.25 |
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 $154.88 Median $158.49 Typical High $234.42 | Professional | 52 · Reduced service | $154.88 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $95.50 | Professional | 53 · Discontinued | $61.66 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $239.88 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $70.79 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $331.13 |
Where Connecticut sits
The same service costs 4.3 times more in Wyoming 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· 19th of 51
$372
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.