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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $478.63 | Professional | None | $275.42 | $338.84 | $478.63 |
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 $251.19 Median $467.74 Typical High $758.58 | Professional | None | $251.19 | $467.74 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $676.08 Typical High $1,230.27 | Facility | None | $549.54 | $676.08 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $676.08 | Professional | None | $316.23 | $389.05 | $676.08 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $616.60 | Professional | None | $501.19 | $501.19 | $616.60 |
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 $223.87 Median $407.38 Typical High $912.01 | Professional | None | $223.87 | $407.38 | $912.01 |
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 $134.90 Median $169.82 Typical High $239.88 | Professional | 52 · Reduced service | $134.90 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $95.50 | Professional | 53 · Discontinued | $54.95 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $251.19 Typical High $354.81 | Professional | 54 · Surgery only | $204.17 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $50.12 Typical High $70.79 | Professional | 55 · Aftercare only | $40.74 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $234.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $190.55 | $234.42 | $331.13 |
Where Connecticut sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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· 8th of 51
$468
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.