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 $144.54 Median $204.17 Typical High $245.47 | Professional | None | $144.54 | $204.17 | $245.47 |
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 $128.82 Median $186.21 Typical High $245.47 | Professional | None | $128.82 | $186.21 | $245.47 |
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 $165.96 Median $218.78 Typical High $338.84 | Professional | None | $165.96 | $218.78 | $338.84 |
ConnectiCare Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $239.88 | Professional | None | $165.96 | $229.09 | $239.88 |
Health New England Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Health New England Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
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 $134.90 Median $213.80 Typical High $380.19 | Professional | None | $134.90 | $213.80 | $380.19 |
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 $75.86 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $37.15 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $37.15 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.62 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $165.96 |
Where Connecticut sits
The same service costs 3.9 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· 25th of 51
$204
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.