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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $331.13 | Professional | None | $141.25 | $229.09 | $331.13 |
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 $134.90 Median $213.80 Typical High $288.40 | Professional | None | $134.90 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $489.78 | Professional | None | $173.78 | $316.23 | $489.78 |
ConnectiCare Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | None | $371.54 | $371.54 | $426.58 |
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 $239.88 Typical High $489.78 | Professional | None | $123.03 | $239.88 | $489.78 |
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 $70.79 Median $95.50 Typical High $162.18 | Professional | 52 · Reduced service | $70.79 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $64.57 | Professional | 53 · Discontinued | $28.18 | $38.02 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $245.47 | Professional | 54 · Surgery only | $104.71 | $144.54 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $48.98 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $32.36 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $229.09 |
Where Connecticut sits
The same service costs 4.5 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· 19th of 51
$229
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.