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 $2,754.23 Median $4,466.84 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $123.03 | Professional | None | $72.44 | $97.72 | $123.03 |
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 $57.54 Median $89.13 Typical High $123.03 | Professional | None | $57.54 | $89.13 | $123.03 |
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 $77.62 Median $109.65 Typical High $169.82 | Professional | None | $77.62 | $109.65 | $169.82 |
ConnectiCare Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | None | $117.49 | $123.03 | $123.03 |
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 $63.10 Median $107.15 Typical High $190.55 | Professional | None | $63.10 | $107.15 | $190.55 |
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 $38.90 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $38.90 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.78 Typical High $23.99 | Professional | 53 · Discontinued | $15.49 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $67.61 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.76 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $63.10 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $53.70 | $63.10 | $83.18 |
Where Connecticut sits
The same service costs 3.8 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· 30th of 51
$97.72
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.