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 $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,819.70 Typical High $2,511.89 | Professional | None | $954.99 | $1,819.70 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $6,025.60 | Facility | None | $851.14 | $4,786.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,511.89 | Professional | None | $831.76 | $1,202.26 | $2,511.89 |
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 $870.96 Median $1,412.54 Typical High $1,698.24 | Professional | None | $870.96 | $1,412.54 | $1,698.24 |
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 $616.60 Median $1,479.11 Typical High $2,884.03 | Professional | None | $616.60 | $1,479.11 | $2,884.03 |
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 $549.54 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $549.54 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $218.78 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $831.76 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $165.96 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $109.65 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $776.25 | $1,122.02 | $1,122.02 |
Where Connecticut sits
The same service costs 7.8 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
$1,698
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.