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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $309.03 | Professional | None | $169.82 | $169.82 | $309.03 |
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 $114.82 Median $194.98 Typical High $309.03 | Professional | None | $114.82 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $407.38 | Professional | None | $165.96 | $269.15 | $407.38 |
ConnectiCare Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | None | $302.00 | $316.23 | $316.23 |
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 $128.82 Median $251.19 Typical High $467.74 | Professional | None | $128.82 | $251.19 | $467.74 |
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 $85.11 Median $85.11 Typical High $154.88 | Professional | 52 · Reduced service | $85.11 | $85.11 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $61.66 | Professional | 53 · Discontinued | $34.67 | $34.67 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $234.42 | Professional | 54 · Surgery only | $128.82 | $128.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $46.77 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $218.78 |
Where Connecticut sits
The same service costs 3.8 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· 24th of 51
$229
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.