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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | None | $831.76 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $1,995.26 | Professional | None | $758.58 | $1,513.56 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,000.00 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,318.26 | $1,819.70 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,380.38 | Professional | None | $891.25 | $1,148.15 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $2,884.03 | Professional | None | $724.44 | $1,288.25 | $2,884.03 |
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 $407.38 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $407.38 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $165.96 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $616.60 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $123.03 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $83.18 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $575.44 | $870.96 | $870.96 |
Where Connecticut sits
The same service costs 6.5 times more in Alaska than in Texas. 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· 11th of 51
$1,445
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.