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 $104.71 Median $123.03 Typical High $151.36 | Professional | None | $104.71 | $123.03 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $263.03 | Professional | None | $117.49 | $190.55 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $173.78 Typical High $223.87 | Facility | None | $51.29 | $173.78 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $288.40 | Professional | None | $134.90 | $186.21 | $288.40 |
ConnectiCare Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $218.78 | Professional | None | $154.88 | $194.98 | $218.78 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $309.03 | Professional | None | $77.62 | $154.88 | $309.03 |
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 $51.29 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $51.29 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $20.89 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $77.62 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $15.49 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.47 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $72.44 | $87.10 | $107.15 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 12th 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.