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 $245.47 Median $354.81 Typical High $354.81 | Professional | None | $245.47 | $354.81 | $354.81 |
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 $234.42 Median $457.09 Typical High $616.60 | Professional | None | $234.42 | $457.09 | $616.60 |
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 $309.03 Median $389.05 Typical High $549.54 | Professional | None | $309.03 | $389.05 | $549.54 |
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 $275.42 Median $354.81 Typical High $407.38 | Professional | None | $275.42 | $354.81 | $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 $213.80 Median $371.54 Typical High $831.76 | Professional | None | $213.80 | $371.54 | $831.76 |
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 $120.23 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $120.23 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $181.97 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $24.55 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $169.82 | $251.19 | $251.19 |
Where Connecticut sits
The same service costs 6.0 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
$417
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.