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 $158.49 Median $218.78 Typical High $302.00 | Professional | None | $158.49 | $218.78 | $302.00 |
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 $208.93 Median $331.13 Typical High $467.74 | Professional | None | $208.93 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $371.54 Typical High $1,000.00 | Facility | None | $316.23 | $371.54 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $467.74 | Professional | None | $213.80 | $281.84 | $467.74 |
ConnectiCare Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $354.81 | Professional | None | $177.83 | $288.40 | $354.81 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $549.54 | Professional | None | $131.83 | $263.03 | $549.54 |
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 $97.72 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $43.65 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $144.54 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $213.80 |
Where Connecticut sits
The same service costs 3.5 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
$302
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.