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 $251.19 Median $338.84 Typical High $512.86 | Professional | None | $251.19 | $338.84 | $512.86 |
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 $281.84 Median $478.63 Typical High $776.25 | Professional | None | $281.84 | $478.63 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $676.08 Typical High $1,122.02 | Facility | None | $457.09 | $676.08 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $676.08 | Professional | None | $331.13 | $426.58 | $676.08 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | None | $537.03 | $537.03 | $630.96 |
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 $234.42 Median $446.68 Typical High $1,000.00 | Professional | None | $234.42 | $446.68 | $1,000.00 |
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 $138.04 Median $169.82 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $102.33 | Professional | 53 · Discontinued | $56.23 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $380.19 | Professional | 54 · Surgery only | $208.93 | $257.04 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $75.86 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.88 Typical High $51.29 | Professional | 56 · Pre-op care only | $28.18 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $194.98 | $239.88 | $354.81 |
Where Connecticut sits
The same service costs 3.7 times more in Wisconsin 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· 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.