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 $114.82 Median $165.96 Typical High $218.78 | Professional | None | $114.82 | $165.96 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $8,709.64 | Facility | None | $1,819.70 | $3,162.28 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $199.53 | Professional | None | $95.50 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $1,000.00 | Facility | None | $213.80 | $245.47 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $281.84 | Professional | None | $128.82 | $177.83 | $281.84 |
ConnectiCare Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | None | $190.55 | $199.53 | $199.53 |
Health New England Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $316.23 | Professional | None | $102.33 | $169.82 | $316.23 |
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 $64.57 Median $69.18 Typical High $100.00 | Professional | 52 · Reduced service | $64.57 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $39.81 | Professional | 53 · Discontinued | $25.70 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $104.71 Typical High $147.91 | Professional | 54 · Surgery only | $95.50 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.89 Typical High $29.51 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $97.72 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $89.13 | $97.72 | $138.04 |
Where Connecticut sits
The same service costs 3.5 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· 28th of 51
$158
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.