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 $4,570.88 Median $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,148.15 | $2,187.76 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $6,309.57 Typical High $7,762.47 | Facility | None | $1,412.54 | $6,309.57 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,819.70 | $2,818.38 |
ConnectiCare Setting Facility Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,348.96 | $1,621.81 |
ConnectiCare Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,778.28 | $1,819.70 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $4,168.69 | Professional | None | $1,174.90 | $1,905.46 | $4,168.69 |
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 $588.84 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $588.84 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $870.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $173.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $117.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $812.83 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 5.5 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· 17th of 51
$2,188
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.