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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $794.33 | Professional | None | $467.74 | $549.54 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $12,022.64 | Facility | None | $1,445.44 | $3,715.35 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $870.96 | Professional | None | $446.68 | $660.69 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $954.99 Typical High $1,318.26 | Professional | 50 · Both sides | $660.69 | $954.99 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,584.89 Typical High $2,818.38 | Facility | None | $891.25 | $1,584.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,096.48 | Professional | None | $575.44 | $676.08 | $1,096.48 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $1,023.29 | Facility | None | $331.13 | $457.09 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $912.01 | Professional | None | $602.56 | $707.95 | $912.01 |
Health New England Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $323.59 Median $630.96 Typical High $1,380.38 | Professional | None | $323.59 | $630.96 | $1,380.38 |
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 $245.47 Median $275.42 Typical High $398.11 | Professional | 52 · Reduced service | $245.47 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $162.18 | Professional | 53 · Discontinued | $97.72 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $363.08 | $407.38 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $120.23 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $79.43 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $562.34 |
Where Connecticut sits
The same service costs 4.8 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
$676
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.