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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $263.03 | Professional | None | $125.89 | $173.78 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $467.74 | Professional | None | $169.82 | $269.15 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $1,230.27 | Facility | None | $269.15 | $323.59 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $316.23 | Professional | None | $154.88 | $218.78 | $316.23 |
ConnectiCare Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $323.59 | Professional | None | $223.87 | $275.42 | $323.59 |
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 $107.15 Median $204.17 Typical High $457.09 | Professional | None | $107.15 | $204.17 | $457.09 |
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 $64.57 Median $85.11 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.88 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $125.89 Typical High $194.98 | Professional | 54 · Surgery only | $97.72 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.12 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $117.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $91.20 | $117.49 | $181.97 |
Where Connecticut sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 10th of 51
$245
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.