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 $186.21 Median $251.19 Typical High $354.81 | Professional | None | $186.21 | $251.19 | $354.81 |
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 $234.42 Median $407.38 Typical High $588.84 | Professional | None | $234.42 | $407.38 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $1,380.38 | Facility | None | $309.03 | $354.81 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $446.68 | Professional | None | $229.09 | $316.23 | $446.68 |
ConnectiCare Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $407.38 | Professional | None | $288.40 | $380.19 | $407.38 |
Health New England Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $162.18 Median $288.40 Typical High $660.69 | Professional | None | $162.18 | $288.40 | $660.69 |
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 $93.33 Median $123.03 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $48.98 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $186.21 Typical High $263.03 | Professional | 54 · Surgery only | $141.25 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $37.15 Typical High $52.48 | Professional | 55 · Aftercare only | $28.18 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $24.55 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $173.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $131.83 | $173.78 | $245.47 |
Where Connecticut sits
The same service costs 3.8 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· 9th of 51
$347
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.