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 $144.54 Median $204.17 Typical High $331.13 | Professional | None | $144.54 | $204.17 | $331.13 |
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 $165.96 Median $281.84 Typical High $457.09 | Professional | None | $165.96 | $281.84 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $426.58 Typical High $691.83 | Professional | 50 · Both sides | $251.19 | $426.58 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $380.19 Typical High $1,380.38 | Facility | None | $331.13 | $380.19 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $489.78 | Professional | None | $186.21 | $295.12 | $489.78 |
ConnectiCare Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $426.58 | Professional | None | $380.19 | $380.19 | $426.58 |
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 $123.03 Median $229.09 Typical High $562.34 | Professional | None | $123.03 | $229.09 | $562.34 |
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 $77.62 Median $102.33 Typical High $165.96 | Professional | 52 · Reduced service | $77.62 | $102.33 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $67.61 | Professional | 53 · Discontinued | $30.90 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $151.36 Typical High $251.19 | Professional | 54 · Surgery only | $117.49 | $151.36 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.20 Typical High $50.12 | Professional | 55 · Aftercare only | $23.44 | $30.20 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $141.25 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $109.65 | $141.25 | $234.42 |
Where Connecticut sits
The same service costs 3.9 times more in Oklahoma 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· 14th of 51
$295
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.