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 $309.03 Median $446.68 Typical High $501.19 | Professional | None | $309.03 | $446.68 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $8,912.51 | Facility | None | $1,819.70 | $3,162.28 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $537.03 Typical High $741.31 | Professional | None | $302.00 | $537.03 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $812.83 Typical High $1,096.48 | Professional | 50 · Both sides | $446.68 | $812.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $1,000.00 | Facility | None | $269.15 | $316.23 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $776.25 | Professional | None | $380.19 | $467.74 | $776.25 |
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 $457.09 Median $467.74 Typical High $575.44 | Professional | None | $457.09 | $467.74 | $575.44 |
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 $229.09 Median $457.09 Typical High $891.25 | Professional | None | $229.09 | $457.09 | $891.25 |
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 $158.49 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $239.88 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $223.87 | $309.03 | $338.84 |
Where Connecticut sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$501
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.