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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $446.68 | Professional | None | $269.15 | $354.81 | $446.68 |
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 $218.78 Median $346.74 Typical High $467.74 | Professional | None | $218.78 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $407.38 Typical High $524.81 | Facility | None | $51.29 | $407.38 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $630.96 | Professional | None | $338.84 | $416.87 | $630.96 |
ConnectiCare Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | None | $446.68 | $467.74 | $467.74 |
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 $257.04 Median $398.11 Typical High $707.95 | Professional | None | $257.04 | $398.11 | $707.95 |
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 $144.54 Median $177.83 Typical High $223.87 | Professional | 52 · Reduced service | $144.54 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $57.54 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $269.15 Typical High $338.84 | Professional | 54 · Surgery only | $213.80 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $53.70 Typical High $67.61 | Professional | 55 · Aftercare only | $42.66 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $35.48 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.84 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $251.19 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $199.53 | $251.19 | $316.23 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 27th of 51
$372
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.