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 $112.20 Median $154.88 Typical High $213.80 | Professional | None | $112.20 | $154.88 | $213.80 |
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 $87.10 Median $144.54 Typical High $208.93 | Professional | None | $87.10 | $144.54 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $229.09 Typical High $295.12 | Facility | None | $51.29 | $229.09 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $281.84 | Professional | None | $123.03 | $169.82 | $281.84 |
ConnectiCare Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | None | $204.17 | $213.80 | $213.80 |
Health New England Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $100.00 Median $173.78 Typical High $331.13 | Professional | None | $100.00 | $173.78 | $331.13 |
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 $66.07 Median $70.79 Typical High $102.33 | Professional | 52 · Reduced service | $66.07 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $41.69 | Professional | 53 · Discontinued | $26.30 | $28.18 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $104.71 Typical High $154.88 | Professional | 54 · Surgery only | $97.72 | $104.71 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.89 Typical High $30.90 | Professional | 55 · Aftercare only | $19.50 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $97.72 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $91.20 | $97.72 | $144.54 |
Where Connecticut sits
The same service costs 3.5 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· 28th of 51
$158
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.