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 $125.89 Median $165.96 Typical High $245.47 | Professional | None | $125.89 | $165.96 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $8,912.51 | Facility | None | $1,819.70 | $3,162.28 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $457.09 | Professional | None | $173.78 | $275.42 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $269.15 Typical High $346.74 | Facility | None | $51.29 | $269.15 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $302.00 | Professional | None | $151.36 | $208.93 | $302.00 |
ConnectiCare Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $302.00 | Professional | None | $218.78 | $257.04 | $302.00 |
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 $104.71 Median $199.53 Typical High $457.09 | Professional | None | $104.71 | $199.53 | $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 $63.10 Median $83.18 Typical High $123.03 | Professional | 52 · Reduced service | $63.10 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $48.98 | Professional | 53 · Discontinued | $25.12 | $33.11 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $125.89 Typical High $186.21 | Professional | 54 · Surgery only | $95.50 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $117.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $89.13 | $117.49 | $173.78 |
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· 10th of 51
$240
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.