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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,230.27 | Professional | None | $758.58 | $977.24 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,041.74 | Professional | None | $758.58 | $1,318.26 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $6,165.95 Typical High $7,762.47 | Facility | None | $851.14 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,137.96 | Professional | None | $912.01 | $1,122.02 | $2,137.96 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,288.25 | $1,698.24 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,318.26 Typical High $2,818.38 | Professional | None | $660.69 | $1,318.26 | $2,818.38 |
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 $380.19 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $380.19 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $194.98 Typical High $245.47 | Professional | 53 · Discontinued | $151.36 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $724.44 Typical High $912.01 | Professional | 54 · Surgery only | $575.44 | $724.44 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $144.54 Typical High $181.97 | Professional | 55 · Aftercare only | $114.82 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $97.72 Typical High $123.03 | Professional | 56 · Pre-op care only | $75.86 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $676.08 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $537.03 | $676.08 | $851.14 |
Where Connecticut sits
The same service costs 5.2 times more in Alaska 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· 11th of 51
$1,318
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.