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 $109.65 Median $147.91 Typical High $204.17 | Professional | None | $109.65 | $147.91 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $8,128.31 | Facility | None | $1,819.70 | $3,162.28 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $177.83 | Professional | None | $95.50 | $128.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $239.88 Typical High $1,000.00 | Facility | None | $208.93 | $239.88 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $245.47 | Professional | None | $120.23 | $165.96 | $245.47 |
ConnectiCare Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $169.82 | Professional | None | $97.72 | $162.18 | $169.82 |
Health New England Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
Health New England Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $158.49 | Professional | None | $83.18 | $83.18 | $158.49 |
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 $95.50 Median $154.88 Typical High $275.42 | Professional | None | $95.50 | $154.88 | $275.42 |
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 $56.23 Median $66.07 Typical High $85.11 | Professional | 52 · Reduced service | $56.23 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.30 Typical High $33.88 | Professional | 53 · Discontinued | $22.39 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $97.72 Typical High $128.82 | Professional | 54 · Surgery only | $85.11 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $25.70 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $91.20 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $79.43 | $91.20 | $120.23 |
Where Connecticut sits
The same service costs 4.1 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· 26th of 51
$145
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.