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 $165.96 Median $229.09 Typical High $316.23 | Professional | None | $165.96 | $229.09 | $316.23 |
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 $213.80 Median $380.19 Typical High $524.81 | Professional | None | $213.80 | $380.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $1,698.24 | Facility | None | $549.54 | $1,380.38 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $407.38 | Professional | None | $208.93 | $281.84 | $407.38 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $363.08 | Professional | None | $263.03 | $338.84 | $363.08 |
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 $151.36 Median $275.42 Typical High $602.56 | Professional | None | $151.36 | $275.42 | $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 $87.10 Median $114.82 Typical High $154.88 | Professional | 52 · Reduced service | $87.10 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $63.10 | Professional | 53 · Discontinued | $34.67 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $169.82 Typical High $234.42 | Professional | 54 · Surgery only | $128.82 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $46.77 | Professional | 55 · Aftercare only | $25.70 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $31.62 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $158.49 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $120.23 | $158.49 | $218.78 |
Where Connecticut sits
The same service costs 4.2 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
$316
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.