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 $363.08 Median $380.19 Typical High $588.84 | Professional | None | $363.08 | $380.19 | $588.84 |
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 $288.40 Median $398.11 Typical High $512.86 | Professional | None | $288.40 | $398.11 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $602.56 Typical High $758.58 | Professional | 50 · Both sides | $436.52 | $602.56 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $1,778.28 | Facility | None | $489.78 | $575.44 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $741.31 | Professional | None | $208.93 | $436.52 | $741.31 |
ConnectiCare Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $630.96 | Professional | None | $275.42 | $457.09 | $630.96 |
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 $245.47 Median $407.38 Typical High $1,148.15 | Professional | None | $245.47 | $407.38 | $1,148.15 |
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 $186.21 Median $190.55 Typical High $295.12 | Professional | 52 · Reduced service | $186.21 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $117.49 | Professional | 53 · Discontinued | $74.13 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $288.40 Typical High $436.52 | Professional | 54 · Surgery only | $275.42 | $288.40 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $57.54 Typical High $87.10 | Professional | 55 · Aftercare only | $54.95 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.02 Typical High $58.88 | Professional | 56 · Pre-op care only | $37.15 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $269.15 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $257.04 | $269.15 | $407.38 |
Where Connecticut sits
The same service costs 3.9 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· 24th of 51
$398
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.