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 $131.83 Median $218.78 Typical High $416.87 | Professional | None | $131.83 | $218.78 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $275.42 | Professional | None | $128.82 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $275.42 Typical High $354.81 | Facility | None | $51.29 | $275.42 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $616.60 | Professional | None | $165.96 | $323.59 | $616.60 |
ConnectiCare Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Health New England Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
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 $123.03 Median $275.42 Typical High $630.96 | Professional | None | $123.03 | $275.42 | $630.96 |
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 $72.44 Median $107.15 Typical High $208.93 | Professional | 52 · Reduced service | $72.44 | $107.15 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $83.18 | Professional | 53 · Discontinued | $28.84 | $42.66 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $309.03 | Professional | 54 · Surgery only | $107.15 | $158.49 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $63.10 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $41.69 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $288.40 |
Where Connecticut sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 25th of 51
$245
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.