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 $154.88 Median $223.87 Typical High $371.54 | Professional | None | $154.88 | $223.87 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $660.69 | Professional | None | $234.42 | $346.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $457.09 Typical High $1,000.00 | Facility | None | $398.11 | $457.09 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $426.58 | Professional | None | $186.21 | $269.15 | $426.58 |
ConnectiCare Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $457.09 | Professional | None | $302.00 | $371.54 | $457.09 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $645.65 | Professional | None | $134.90 | $263.03 | $645.65 |
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 $79.43 Median $104.71 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $104.71 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $41.69 Typical High $72.44 | Professional | 53 · Discontinued | $31.62 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $154.88 Typical High $269.15 | Professional | 54 · Surgery only | $117.49 | $154.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $30.90 Typical High $53.70 | Professional | 55 · Aftercare only | $23.44 | $30.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $20.89 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.85 | $20.89 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $144.54 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $109.65 | $144.54 | $251.19 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$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.