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 $275.42 Median $354.81 Typical High $436.52 | Professional | None | $275.42 | $354.81 | $436.52 |
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 $234.42 Median $331.13 Typical High $446.68 | Professional | None | $234.42 | $331.13 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $478.63 Typical High $1,000.00 | Facility | None | $416.87 | $478.63 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $660.69 | Professional | None | $354.81 | $446.68 | $660.69 |
ConnectiCare Setting Professional Modifier None Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | None | $426.58 | $446.68 | $446.68 |
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 $251.19 Median $398.11 Typical High $691.83 | Professional | None | $251.19 | $398.11 | $691.83 |
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 $141.25 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $141.25 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $56.23 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $208.93 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $194.98 | $245.47 | $302.00 |
Where Connecticut sits
The same service costs 4.7 times more in Alaska than in Texas. 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
$380
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.