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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $275.42 | Professional | None | $138.04 | $181.97 | $275.42 |
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 $169.82 Median $302.00 Typical High $512.86 | Professional | None | $169.82 | $302.00 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $436.52 | Professional | None | $181.97 | $275.42 | $436.52 |
ConnectiCare Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | None | $346.74 | $346.74 | $416.87 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $549.54 | Professional | None | $131.83 | $263.03 | $549.54 |
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 $83.18 Median $91.20 Typical High $138.04 | Professional | 52 · Reduced service | $83.18 | $91.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $36.31 Typical High $54.95 | Professional | 53 · Discontinued | $33.11 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $208.93 | Professional | 54 · Surgery only | $125.89 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $41.69 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.20 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.60 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $125.89 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $117.49 | $125.89 | $194.98 |
Where Connecticut sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 11th of 51
$282
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.