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 $190.55 Median $275.42 Typical High $407.38 | Professional | None | $190.55 | $275.42 | $407.38 |
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 $245.47 Median $398.11 Typical High $616.60 | Professional | None | $245.47 | $398.11 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $467.74 Typical High $1,000.00 | Facility | None | $407.38 | $467.74 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $602.56 | Professional | None | $218.78 | $309.03 | $602.56 |
ConnectiCare Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
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 $173.78 Median $338.84 Typical High $776.25 | Professional | None | $173.78 | $338.84 | $776.25 |
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 $109.65 Median $131.83 Typical High $204.17 | Professional | 52 · Reduced service | $109.65 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $302.00 | Professional | 54 · Surgery only | $165.96 | $199.53 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.30 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $281.84 |
Where Connecticut sits
The same service costs 4.3 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· 9th of 51
$389
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.