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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $891.25 Typical High $891.25 | Professional | None | $616.60 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $21,877.62 Typical High $25,703.96 | Facility | None | $1,548.82 | $21,877.62 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $1,047.13 Typical High $1,445.44 | Professional | None | $537.03 | $1,047.13 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $9,332.54 | Facility | None | $851.14 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,445.44 | Professional | None | $870.96 | $977.24 | $1,445.44 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,047.13 | Professional | None | $691.83 | $912.01 | $1,047.13 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $467.74 Median $870.96 Typical High $1,621.81 | Professional | None | $467.74 | $870.96 | $1,621.81 |
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 $309.03 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $309.03 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $123.03 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $467.74 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $93.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $61.66 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $436.52 | $630.96 | $630.96 |
Where Connecticut sits
The same service costs 8.1 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· 16th of 51
$1,000
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.