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 $169.82 Median $218.78 Typical High $346.74 | Professional | None | $169.82 | $218.78 | $346.74 |
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 $229.09 Median $354.81 Typical High $575.44 | Professional | None | $229.09 | $354.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $1,000.00 | Facility | None | $331.13 | $389.05 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $446.68 | Professional | None | $204.17 | $338.84 | $446.68 |
ConnectiCare Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $398.11 | Professional | None | $288.40 | $380.19 | $398.11 |
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 $144.54 Median $281.84 Typical High $602.56 | Professional | None | $144.54 | $281.84 | $602.56 |
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 $85.11 Median $109.65 Typical High $173.78 | Professional | 52 · Reduced service | $85.11 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $70.79 | Professional | 53 · Discontinued | $33.88 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $263.03 | Professional | 54 · Surgery only | $128.82 | $165.96 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $52.48 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $245.47 |
Where Connecticut sits
The same service costs 3.5 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· 8th of 51
$339
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.