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 $229.09 Typical High $354.81 | Professional | None | $169.82 | $229.09 | $354.81 |
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 $125.89 Median $218.78 Typical High $331.13 | Professional | None | $125.89 | $218.78 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $398.11 Typical High $512.86 | Facility | None | $51.29 | $398.11 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $489.78 | Professional | None | $204.17 | $288.40 | $489.78 |
ConnectiCare Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | None | $316.23 | $331.13 | $331.13 |
Health New England Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Health New England Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $478.63 | Professional | None | $144.54 | $257.04 | $478.63 |
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 $95.50 Median $95.50 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $60.26 | Professional | 53 · Discontinued | $38.02 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $144.54 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $44.67 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $134.90 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $134.90 | $208.93 |
Where Connecticut sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 23rd of 51
$257
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.