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 $691.83 Median $954.99 Typical High $954.99 | Professional | None | $691.83 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $8,912.51 | Facility | None | $3,548.13 | $4,168.69 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,698.24 | Professional | None | $645.65 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $933.25 | $1,819.70 | $2,511.89 |
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 $977.24 Median $1,096.48 Typical High $1,621.81 | Professional | None | $977.24 | $1,096.48 | $1,621.81 |
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 $812.83 Median $1,023.29 Typical High $1,202.26 | Professional | None | $812.83 | $1,023.29 | $1,202.26 |
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 $537.03 Median $1,000.00 Typical High $1,862.09 | Professional | None | $537.03 | $1,000.00 | $1,862.09 |
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 $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $346.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $524.81 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $104.71 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $69.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $489.78 | $676.08 | $676.08 |
Where Connecticut sits
The same service costs 8.5 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
$1,122
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.