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 $630.96 Median $724.44 Typical High $1,000.00 | Professional | None | $630.96 | $724.44 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $11,748.98 Typical High $28,183.83 | Facility | None | $6,309.57 | $11,748.98 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,148.15 | Professional | None | $588.84 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,388.44 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | None | $776.25 | $912.01 | $1,380.38 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,174.90 | Professional | None | $776.25 | $954.99 | $1,174.90 |
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 $436.52 Median $851.14 Typical High $1,737.80 | Professional | None | $436.52 | $851.14 | $1,737.80 |
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 $316.23 Median $363.08 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $363.08 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $199.53 | Professional | 53 · Discontinued | $125.89 | $144.54 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $758.58 | Professional | 54 · Surgery only | $467.74 | $549.54 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $707.95 |
Where Connecticut sits
The same service costs 5.8 times more in Alaska than in Texas. 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
$912
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.