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 $1,000.00 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,584.89 Typical High $1,995.26 | Professional | None | $891.25 | $1,584.89 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $2,344.23 Typical High $3,019.95 | Professional | 50 · Both sides | $1,318.26 | $2,344.23 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $1,000.00 Typical High $1,258.93 | Professional | 62 · Two surgeons | $549.54 | $1,000.00 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $2,951.21 | Facility | None | $851.14 | $2,290.87 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,187.76 | Professional | None | $812.83 | $1,174.90 | $2,187.76 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,548.82 | Professional | None | $616.60 | $1,023.29 | $1,548.82 |
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 $831.76 Median $1,148.15 Typical High $3,090.30 | Professional | None | $831.76 | $1,148.15 | $3,090.30 |
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 $549.54 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $549.54 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $218.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $831.76 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $776.25 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 7.4 times more in Alaska 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· 15th of 51
$1,479
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.