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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $676.08 | Professional | None | $436.52 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $12,302.69 Typical High $87,096.36 | Facility | None | $2,754.23 | $12,302.69 | $87,096.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $891.25 | Professional | None | $380.19 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $5,754.40 | Facility | None | $851.14 | $4,365.16 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,023.29 | Professional | None | $478.63 | $645.65 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,380.38 | Professional | None | $416.87 | $691.83 | $1,380.38 |
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 $218.78 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $87.10 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $64.57 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $467.74 |
Where Connecticut sits
The same service costs 5.5 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· 24th of 51
$759
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.