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 $194.98 Median $269.15 Typical High $275.42 | Professional | None | $194.98 | $269.15 | $275.42 |
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 $190.55 Median $380.19 Typical High $512.86 | Professional | None | $190.55 | $380.19 | $512.86 |
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 $245.47 Median $288.40 Typical High $446.68 | Professional | None | $245.47 | $288.40 | $446.68 |
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 $229.09 Median $288.40 Typical High $316.23 | Professional | None | $229.09 | $288.40 | $316.23 |
Health New England Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
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 $169.82 Median $302.00 Typical High $660.69 | Professional | None | $169.82 | $302.00 | $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 $97.72 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $97.72 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $38.90 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $144.54 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $28.84 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.50 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $190.55 |
Where Connecticut sits
The same service costs 5.9 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· 13th of 51
$324
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.