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 $123.03 Median $181.97 Typical High $223.87 | Professional | None | $123.03 | $181.97 | $223.87 |
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 $112.20 Median $218.78 Typical High $295.12 | Professional | None | $112.20 | $218.78 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $186.21 Typical High $239.88 | Facility | None | $51.29 | $186.21 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $295.12 | Professional | None | $154.88 | $190.55 | $295.12 |
ConnectiCare Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $208.93 | Professional | None | $154.88 | $169.82 | $208.93 |
Health New England Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
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 $93.33 Median $177.83 Typical High $331.13 | Professional | None | $93.33 | $177.83 | $331.13 |
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 $61.66 Median $91.20 Typical High $93.33 | Professional | 52 · Reduced service | $61.66 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $37.15 | Professional | 53 · Discontinued | $24.55 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $134.90 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $28.18 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $125.89 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $87.10 | $125.89 | $128.82 |
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· 12th of 51
$204
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.