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 $117.49 Median $190.55 Typical High $331.13 | Professional | None | $117.49 | $190.55 | $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 $120.23 Median $190.55 Typical High $245.47 | Professional | None | $120.23 | $190.55 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $275.42 Typical High $363.08 | Professional | 50 · Both sides | $177.83 | $275.42 | $363.08 |
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 $147.91 Median $234.42 Typical High $436.52 | Professional | None | $147.91 | $234.42 | $436.52 |
ConnectiCare Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | None | $295.12 | $295.12 | $380.19 |
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 $109.65 Median $223.87 Typical High $467.74 | Professional | None | $109.65 | $223.87 | $467.74 |
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 $64.57 Median $95.50 Typical High $165.96 | Professional | 52 · Reduced service | $64.57 | $95.50 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $67.61 | Professional | 53 · Discontinued | $25.70 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $251.19 | Professional | 54 · Surgery only | $97.72 | $144.54 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $50.12 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $234.42 |
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· 21st 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.