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 $173.78 Median $338.84 Typical High $588.84 | Professional | None | $173.78 | $338.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $7,943.28 | Facility | None | $2,884.03 | $3,715.35 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $371.54 | Professional | None | $204.17 | $281.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $1,905.46 | Facility | None | $549.54 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $489.78 Typical High $891.25 | Professional | None | $229.09 | $489.78 | $891.25 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $831.76 | Professional | None | $457.09 | $676.08 | $831.76 |
Health New England Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Health New England Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | None | $229.09 | $346.74 | $346.74 |
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 $128.82 Median $371.54 Typical High $977.24 | Professional | None | $128.82 | $371.54 | $977.24 |
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 $109.65 Median $165.96 Typical High $288.40 | Professional | 52 · Reduced service | $109.65 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $66.07 Typical High $114.82 | Professional | 53 · Discontinued | $44.67 | $66.07 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $245.47 Typical High $426.58 | Professional | 54 · Surgery only | $165.96 | $245.47 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $48.98 Typical High $87.10 | Professional | 55 · Aftercare only | $33.11 | $48.98 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.11 Typical High $57.54 | Professional | 56 · Pre-op care only | $21.88 | $33.11 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $229.09 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $154.88 | $229.09 | $398.11 |
Where Connecticut sits
The same service costs 4.0 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· 28th of 51
$331
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.