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 $138.04 Median $257.04 Typical High $436.52 | Professional | None | $138.04 | $257.04 | $436.52 |
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 $208.93 Typical High $275.42 | Professional | None | $128.82 | $208.93 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $446.68 Typical High $588.84 | Facility | None | $51.29 | $446.68 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $630.96 | Professional | None | $169.82 | $275.42 | $630.96 |
ConnectiCare Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | None | $371.54 | $371.54 | $537.03 |
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 $85.11 | Professional | 53 · Discontinued | $28.84 | $42.66 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $316.23 | Professional | 54 · Surgery only | $109.65 | $162.18 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $63.10 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $295.12 |
Where Connecticut sits
The same service costs 3.9 times more in Alaska 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· 24th of 51
$257
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.