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 $169.82 Median $245.47 Typical High $331.13 | Professional | None | $169.82 | $245.47 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $331.13 | Professional | None | $141.25 | $223.87 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $380.19 Typical High $1,000.00 | Facility | None | $323.59 | $380.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $436.52 | Professional | None | $173.78 | $269.15 | $436.52 |
ConnectiCare Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $331.13 | Professional | None | $229.09 | $316.23 | $331.13 |
Health New England Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,122.02 | Professional | None | $371.54 | $371.54 | $1,122.02 |
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 $151.36 Median $269.15 Typical High $512.86 | Professional | None | $151.36 | $269.15 | $512.86 |
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 $102.33 Median $109.65 Typical High $162.18 | Professional | 52 · Reduced service | $102.33 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $64.57 | Professional | 53 · Discontinued | $40.74 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $162.18 Typical High $245.47 | Professional | 54 · Surgery only | $154.88 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $48.98 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $32.36 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $151.36 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $144.54 | $151.36 | $229.09 |
Where Connecticut sits
The same service costs 3.4 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· 31st of 51
$245
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.