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 $123.03 Median $165.96 Typical High $223.87 | Professional | None | $123.03 | $165.96 | $223.87 |
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 $162.18 Median $269.15 Typical High $371.54 | Professional | None | $162.18 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $229.09 Typical High $1,000.00 | Facility | None | $199.53 | $229.09 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $288.40 | Professional | None | $151.36 | $199.53 | $288.40 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $257.04 | Professional | None | $186.21 | $245.47 | $257.04 |
Health New England Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $104.71 Median $194.98 Typical High $426.58 | Professional | None | $104.71 | $194.98 | $426.58 |
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 $61.66 Median $83.18 Typical High $112.20 | Professional | 52 · Reduced service | $61.66 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $33.11 Typical High $45.71 | Professional | 53 · Discontinued | $24.55 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $93.33 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.60 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.30 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $114.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $87.10 | $114.82 | $158.49 |
Where Connecticut sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 12th of 51
$224
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.