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 $263.03 Median $380.19 Typical High $416.87 | Professional | None | $263.03 | $380.19 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $4,786.30 Typical High $24,547.09 | Facility | None | $1,819.70 | $4,786.30 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $630.96 | Professional | None | $251.19 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $707.95 Typical High $954.99 | Professional | 50 · Both sides | $371.54 | $707.95 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $1,000.00 | Facility | None | $269.15 | $316.23 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $660.69 | Professional | None | $323.59 | $407.38 | $660.69 |
ConnectiCare Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
Health New England Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $199.53 Median $380.19 Typical High $758.58 | Professional | None | $199.53 | $380.19 | $758.58 |
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 $134.90 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $77.62 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $204.17 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $38.02 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.92 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $269.15 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $190.55 | $269.15 | $281.84 |
Where Connecticut sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 13th of 51
$417
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.