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 $125.89 Median $181.97 Typical High $245.47 | Professional | None | $125.89 | $181.97 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $7,943.28 | Facility | None | $3,311.31 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $245.47 | Professional | None | $107.15 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $1,000.00 | Facility | None | $275.42 | $323.59 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $331.13 | Professional | None | $107.15 | $194.98 | $331.13 |
ConnectiCare Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $245.47 | Professional | None | $154.88 | $234.42 | $245.47 |
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 $107.15 Median $204.17 Typical High $389.05 | Professional | None | $107.15 | $204.17 | $389.05 |
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 $75.86 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $75.86 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $114.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $37.15 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $173.78 |
Where Connecticut sits
The same service costs 3.6 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· 27th of 51
$195
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.