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 $302.00 Median $426.58 Typical High $562.34 | Professional | None | $302.00 | $426.58 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $4,786.30 Typical High $12,589.25 | Facility | None | $1,819.70 | $4,786.30 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $707.95 | Professional | None | $288.40 | $512.86 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $758.58 Typical High $1,071.52 | Professional | 50 · Both sides | $436.52 | $758.58 | $1,071.52 |
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 $371.54 Median $457.09 Typical High $758.58 | Professional | None | $371.54 | $457.09 | $758.58 |
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 $436.52 Median $457.09 Typical High $562.34 | Professional | None | $436.52 | $457.09 | $562.34 |
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 $223.87 Median $436.52 Typical High $870.96 | Professional | None | $223.87 | $436.52 | $870.96 |
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 $154.88 Median $213.80 Typical High $234.42 | Professional | 52 · Reduced service | $154.88 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $61.66 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $229.09 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $45.71 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.90 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $213.80 | $302.00 | $331.13 |
Where Connecticut sits
The same service costs 5.5 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
$490
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.