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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $389.05 | Professional | None | $208.93 | $309.03 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $28,183.83 | Facility | None | $1,819.70 | $3,162.28 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $489.78 | Professional | None | $199.53 | $363.08 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $288.40 Typical High $371.54 | Facility | None | $51.29 | $288.40 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $524.81 | Professional | None | $269.15 | $331.13 | $524.81 |
ConnectiCare Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $380.19 | Professional | None | $281.84 | $323.59 | $380.19 |
Health New England Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $354.81 | Professional | None | $162.18 | $162.18 | $354.81 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $158.49 Median $309.03 Typical High $588.84 | Professional | None | $158.49 | $309.03 | $588.84 |
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 $107.15 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $107.15 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $42.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $162.18 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $32.36 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.38 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $151.36 | $213.80 | $229.09 |
Where Connecticut sits
The same service costs 5.1 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· 13th of 51
$339
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.