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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $316.23 | Professional | None | $134.90 | $199.53 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $537.03 | Professional | None | $194.98 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $1,380.38 | Facility | None | $331.13 | $389.05 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $501.19 | Professional | None | $173.78 | $251.19 | $501.19 |
ConnectiCare Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Professional | None | $331.13 | $331.13 | $436.52 |
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 $128.82 Median $263.03 Typical High $602.56 | Professional | None | $128.82 | $263.03 | $602.56 |
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 $81.28 Median $95.50 Typical High $154.88 | Professional | 52 · Reduced service | $81.28 | $95.50 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $63.10 | Professional | 53 · Discontinued | $32.36 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $144.54 Typical High $234.42 | Professional | 54 · Surgery only | $123.03 | $144.54 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.84 Typical High $46.77 | Professional | 55 · Aftercare only | $24.55 | $28.84 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $134.90 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $114.82 | $134.90 | $218.78 |
Where Connecticut sits
The same service costs 3.8 times more in Wisconsin than in Kentucky. 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
$295
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.