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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | None | $977.24 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $2,137.96 | Professional | None | $851.14 | $1,584.89 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,445.44 | $2,290.87 |
ConnectiCare Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $3,019.95 | Professional | None | $933.25 | $1,479.11 | $3,019.95 |
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 $478.63 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $478.63 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $144.54 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $97.72 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $676.08 | $1,023.29 | $1,023.29 |
Where Connecticut sits
The same service costs 4.7 times more in Alaska than in Texas. 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· 13th of 51
$1,585
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.