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 $346.74 Median $489.78 Typical High $812.83 | Professional | None | $346.74 | $489.78 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $10,964.78 | Facility | None | $3,548.13 | $4,168.69 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $758.58 | Professional | None | $380.19 | $575.44 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $851.14 Typical High $1,122.02 | Professional | 50 · Both sides | $562.34 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $2,187.76 | Facility | None | $741.31 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $977.24 | Professional | None | $489.78 | $602.56 | $977.24 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $812.83 | Professional | None | $549.54 | $630.96 | $812.83 |
Health New England Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $275.42 Median $549.54 Typical High $1,230.27 | Professional | None | $275.42 | $549.54 | $1,230.27 |
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 $213.80 Median $234.42 Typical High $354.81 | Professional | 52 · Reduced service | $213.80 | $234.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $141.25 | Professional | 53 · Discontinued | $85.11 | $93.33 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $537.03 | Professional | 54 · Surgery only | $316.23 | $346.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $107.15 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $70.79 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $501.19 |
Where Connecticut sits
The same service costs 4.9 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
$589
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.