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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,023.29 | Professional | None | $691.83 | $1,000.00 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,748.98 Typical High $13,803.84 | Facility | None | $2,754.23 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $1,621.81 | Professional | None | $630.96 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,778.28 Typical High $2,454.71 | Professional | 50 · Both sides | $933.25 | $1,778.28 | $2,454.71 |
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 $977.24 Median $1,071.52 Typical High $1,621.81 | Professional | None | $977.24 | $1,071.52 | $1,621.81 |
ConnectiCare Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Facility | None | $13,489.63 | $13,489.63 | $13,489.63 |
ConnectiCare Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,174.90 | Professional | None | $758.58 | $1,000.00 | $1,174.90 |
Health New England Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $15,848.93 | Professional | None | $15,848.93 | $15,848.93 | $15,848.93 |
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 $524.81 Median $977.24 Typical High $1,905.46 | Professional | None | $524.81 | $977.24 | $1,905.46 |
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 $346.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $346.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $138.04 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $69.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $489.78 | $707.95 | $707.95 |
Where Connecticut sits
The same service costs 7.4 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· 18th of 51
$1,096
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.