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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $316.23 | Professional | None | $173.78 | $229.09 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $269.15 | Professional | None | $169.82 | $213.80 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $1,000.00 | Facility | None | $257.04 | $302.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $478.63 | Professional | None | $199.53 | $251.19 | $478.63 |
ConnectiCare Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | None | $223.87 | $234.42 | $234.42 |
Health New England Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $562.34 | Facility | None | $281.84 | $281.84 | $562.34 |
Health New England Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $407.38 | Professional | None | $162.18 | $239.88 | $407.38 |
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 $87.10 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $87.10 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $131.83 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $123.03 | $158.49 | $181.97 |
Where Connecticut sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 31st of 51
$224
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.