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 $158.49 Median $208.93 Typical High $269.15 | Professional | None | $158.49 | $208.93 | $269.15 |
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 $112.20 Median $169.82 Typical High $269.15 | Professional | None | $112.20 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $275.42 Typical High $354.81 | Facility | None | $51.29 | $275.42 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $354.81 | Professional | None | $158.49 | $218.78 | $354.81 |
ConnectiCare Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
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 $131.83 Median $218.78 Typical High $416.87 | Professional | None | $131.83 | $218.78 | $416.87 |
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 $83.18 Median $91.20 Typical High $131.83 | Professional | 52 · Reduced service | $83.18 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $36.31 Typical High $52.48 | Professional | 53 · Discontinued | $33.11 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $138.04 Typical High $194.98 | Professional | 54 · Surgery only | $125.89 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $27.54 Typical High $39.81 | Professional | 55 · Aftercare only | $25.12 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.20 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.60 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $128.82 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $117.49 | $128.82 | $181.97 |
Where Connecticut sits
The same service costs 3.5 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· 30th of 51
$200
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.