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 $74.13 Median $107.15 Typical High $169.82 | Professional | None | $74.13 | $107.15 | $169.82 |
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 $61.66 Median $93.33 Typical High $141.25 | Professional | None | $61.66 | $93.33 | $141.25 |
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 $67.61 Median $114.82 Typical High $190.55 | Professional | None | $67.61 | $114.82 | $190.55 |
ConnectiCare Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $144.54 | Professional | None | $70.79 | $144.54 | $144.54 |
Health New England Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $489.78 | Professional | None | $120.23 | $177.83 | $489.78 |
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 $60.26 Median $114.82 Typical High $223.87 | Professional | None | $60.26 | $114.82 | $223.87 |
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 $43.65 Median $44.67 Typical High $70.79 | Professional | 52 · Reduced service | $43.65 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $28.18 | Professional | 53 · Discontinued | $17.38 | $17.78 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $104.71 | Professional | 54 · Surgery only | $66.07 | $66.07 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $21.38 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $61.66 | $61.66 | $97.72 |
Where Connecticut sits
The same service costs 3.9 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· 26th of 51
$110
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.