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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $398.11 | Professional | None | $147.91 | $251.19 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,819.70 | $3,162.28 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $323.59 | Professional | None | $186.21 | $251.19 | $323.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $331.13 Typical High $467.74 | Professional | 50 · Both sides | $218.78 | $331.13 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $1,000.00 | Facility | None | $331.13 | $389.05 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $512.86 | Professional | None | $204.17 | $316.23 | $512.86 |
ConnectiCare Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $436.52 | Professional | None | $288.40 | $331.13 | $436.52 |
Health New England Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Health New England Setting Professional Modifier None Typical Low $199.53 Median $436.52 Typical High $436.52 | Professional | None | $199.53 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $117.49 Median $281.84 Typical High $645.65 | Professional | None | $117.49 | $281.84 | $645.65 |
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 $100.00 Median $112.20 Typical High $194.98 | Professional | 52 · Reduced service | $100.00 | $112.20 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $44.67 Typical High $77.62 | Professional | 53 · Discontinued | $39.81 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $169.82 Typical High $295.12 | Professional | 54 · Surgery only | $147.91 | $169.82 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $58.88 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.39 Typical High $38.90 | Professional | 56 · Pre-op care only | $19.95 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $158.49 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $138.04 | $158.49 | $275.42 |
Where Connecticut sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 19th of 51
$257
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.