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 $489.78 Median $707.95 Typical High $707.95 | Professional | None | $489.78 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $10,964.78 | Facility | None | $3,548.13 | $4,168.69 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $831.76 Typical High $1,148.15 | Professional | None | $436.52 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $1,258.93 Typical High $1,737.80 | Professional | 50 · Both sides | $660.69 | $1,258.93 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,778.28 Typical High $2,238.72 | Facility | None | $549.54 | $1,778.28 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,174.90 | Professional | None | $660.69 | $758.58 | $1,174.90 |
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 $602.56 Median $691.83 Typical High $812.83 | Professional | None | $602.56 | $691.83 | $812.83 |
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 $371.54 Median $707.95 Typical High $1,348.96 | Professional | None | $371.54 | $707.95 | $1,348.96 |
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 $245.47 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $245.47 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $97.72 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $72.44 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $48.98 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $489.78 | $489.78 |
Where Connecticut sits
The same service costs 7.6 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· 12th of 51
$832
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.