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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $776.25 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,445.44 | Professional | None | $588.84 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,659.59 Typical High $2,137.96 | Professional | 50 · Both sides | $870.96 | $1,659.59 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $691.83 Typical High $912.01 | Professional | 62 · Two surgeons | $371.54 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,630.78 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,479.11 | Professional | None | $562.34 | $794.33 | $1,479.11 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,122.02 | Professional | None | $407.38 | $691.83 | $1,122.02 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $2,187.76 | Professional | None | $562.34 | $776.25 | $2,187.76 |
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 $389.05 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $575.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $114.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $77.62 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $724.44 | $724.44 |
Where Connecticut sits
The same service costs 8.5 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· 17th of 51
$1,047
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.