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 $125.89 Median $162.18 Typical High $229.09 | Professional | None | $125.89 | $162.18 | $229.09 |
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 $95.50 Median $162.18 Typical High $229.09 | Professional | None | $95.50 | $162.18 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $234.42 Typical High $302.00 | Facility | None | $51.29 | $234.42 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $309.03 | Professional | None | $138.04 | $190.55 | $309.03 |
ConnectiCare Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | None | $218.78 | $229.09 | $229.09 |
Health New England Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $112.20 Median $186.21 Typical High $354.81 | Professional | None | $112.20 | $186.21 | $354.81 |
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 $70.79 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $70.79 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $28.84 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $120.23 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $112.20 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $112.20 | $158.49 |
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· 30th of 51
$174
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.