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 $398.11 Median $691.83 Typical High $1,659.59 | Professional | None | $398.11 | $691.83 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $11,481.54 Typical High $13,489.63 | Facility | None | $2,754.23 | $11,481.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $2,951.21 | Professional | None | $562.34 | $1,071.52 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,621.81 Typical High $4,466.84 | Professional | 50 · Both sides | $851.14 | $1,621.81 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $2,691.53 | Professional | None | $549.54 | $1,000.00 | $2,691.53 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
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 $426.58 Median $1,318.26 Typical High $3,715.35 | Professional | None | $426.58 | $1,318.26 | $3,715.35 |
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 $275.42 Median $338.84 Typical High $831.76 | Professional | 52 · Reduced service | $275.42 | $338.84 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $138.04 Typical High $331.13 | Professional | 53 · Discontinued | $109.65 | $138.04 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $1,230.27 | Professional | 54 · Surgery only | $416.87 | $512.86 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $245.47 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $1,148.15 |
Where Connecticut sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,445
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.