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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $512.86 | Professional | None | $281.84 | $346.74 | $512.86 |
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 $204.17 Median $363.08 Typical High $512.86 | Professional | None | $204.17 | $363.08 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $933.25 Typical High $1,548.82 | Facility | None | $645.65 | $933.25 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $758.58 | Professional | None | $346.74 | $501.19 | $758.58 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $831.76 | Facility | None | $331.13 | $457.09 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | None | $489.78 | $512.86 | $512.86 |
Health New England Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Health New England Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $562.34 | Professional | None | $223.87 | $223.87 | $562.34 |
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 $245.47 Median $416.87 Typical High $794.33 | Professional | None | $245.47 | $416.87 | $794.33 |
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 $162.18 Median $162.18 Typical High $251.19 | Professional | 52 · Reduced service | $162.18 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $100.00 | Professional | 53 · Discontinued | $64.57 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $380.19 | Professional | 54 · Surgery only | $239.88 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $354.81 |
Where Connecticut sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 29th of 51
$389
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.