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 $208.93 Median $309.03 Typical High $316.23 | Professional | None | $208.93 | $309.03 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $9,772.37 | Facility | None | $3,548.13 | $6,025.60 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $407.38 Typical High $549.54 | Professional | None | $204.17 | $407.38 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,162.28 Typical High $4,073.80 | Facility | None | $1,000.00 | $3,162.28 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $489.78 | Professional | None | $263.03 | $338.84 | $489.78 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $3,981.07 | Facility | None | $630.96 | $1,023.29 | $3,981.07 |
ConnectiCare Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $354.81 | Professional | None | $251.19 | $331.13 | $354.81 |
Health New England Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,905.46 | $1,905.46 | $1,949.84 |
Health New England Setting Professional Modifier None Typical Low $204.17 Median $398.11 Typical High $407.38 | Professional | None | $204.17 | $398.11 | $407.38 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $724.44 | Professional | None | $186.21 | $323.59 | $724.44 |
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 $104.71 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $104.71 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $41.69 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $31.62 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.89 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $147.91 | $213.80 | $213.80 |
Where Connecticut sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 12th of 51
$363
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.