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 $323.59 Median $426.58 Typical High $537.03 | Professional | None | $323.59 | $426.58 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $676.08 | Professional | None | $281.84 | $501.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $2,691.53 | Facility | None | $851.14 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $741.31 | Professional | None | $416.87 | $512.86 | $741.31 |
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 $380.19 Median $467.74 Typical High $575.44 | Professional | None | $380.19 | $467.74 | $575.44 |
Health New England Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $223.87 Median $457.09 Typical High $831.76 | Professional | None | $223.87 | $457.09 | $831.76 |
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 $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $234.42 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $46.77 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $218.78 | $302.00 | $338.84 |
Where Connecticut sits
The same service costs 6.8 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· 15th of 51
$479
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.