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 $363.08 Median $512.86 Typical High $575.44 | Professional | None | $363.08 | $512.86 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,819.70 | $3,162.28 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $831.76 | Professional | None | $363.08 | $630.96 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $933.25 Typical High $1,258.93 | Professional | 50 · Both sides | $549.54 | $933.25 | $1,258.93 |
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 $457.09 Median $549.54 Typical High $912.01 | Professional | None | $457.09 | $549.54 | $912.01 |
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 $537.03 Median $549.54 Typical High $676.08 | Professional | None | $537.03 | $549.54 | $676.08 |
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 $269.15 Median $537.03 Typical High $1,047.13 | Professional | None | $269.15 | $537.03 | $1,047.13 |
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 $186.21 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $186.21 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $56.23 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $398.11 |
Where Connecticut sits
The same service costs 5.1 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· 13th of 51
$575
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.