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 $776.25 Median $1,148.15 Typical High $1,348.96 | Professional | None | $776.25 | $1,148.15 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,698.24 | Professional | None | $707.95 | $1,202.26 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,165.95 Typical High $7,762.47 | Facility | None | $741.31 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,318.26 | $1,819.70 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,348.96 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,089.30 | Professional | None | $602.56 | $1,122.02 | $2,089.30 |
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 $407.38 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $407.38 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $165.96 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $616.60 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $123.03 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $83.18 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $933.25 |
Where Connecticut sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$1,230
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.