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 $190.55 Median $251.19 Typical High $316.23 | Professional | None | $190.55 | $251.19 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $8,128.31 | Facility | None | $3,311.31 | $3,981.07 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $302.00 | Professional | None | $162.18 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,187.76 | Facility | None | $741.31 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $426.58 | Professional | None | $204.17 | $269.15 | $426.58 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | None | $281.84 | $295.12 | $295.12 |
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 $165.96 Median $263.03 Typical High $467.74 | Professional | None | $165.96 | $263.03 | $467.74 |
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 $93.33 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $93.33 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $38.02 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $169.82 Typical High $223.87 | Professional | 54 · Surgery only | $141.25 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $44.67 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $18.62 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $208.93 |
Where Connecticut sits
The same service costs 4.7 times more in Alaska 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· 28th of 51
$251
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.