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 $251.19 Typical High $398.11 | Professional | None | $173.78 | $251.19 | $398.11 |
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 $281.84 Typical High $371.54 | Professional | None | $208.93 | $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 $218.78 Median $331.13 Typical High $575.44 | Professional | None | $218.78 | $331.13 | $575.44 |
ConnectiCare Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $457.09 | Professional | None | $323.59 | $380.19 | $457.09 |
Health New England Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | None | $323.59 | $323.59 | $331.13 |
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 $138.04 Median $295.12 Typical High $691.83 | Professional | None | $138.04 | $295.12 | $691.83 |
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 $117.49 Median $123.03 Typical High $199.53 | Professional | 52 · Reduced service | $117.49 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $79.43 | Professional | 53 · Discontinued | $47.86 | $48.98 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $173.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $173.78 | $275.42 |
Where Connecticut sits
The same service costs 4.5 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· 19th of 51
$288
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.