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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $758.58 | Professional | None | $478.63 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $954.99 | Professional | None | $389.05 | $660.69 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,548.13 Typical High $4,365.16 | Facility | None | $741.31 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,096.48 | Professional | None | $549.54 | $660.69 | $1,096.48 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | None | $691.83 | $691.83 | $776.25 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $1,348.96 | Professional | None | $416.87 | $562.34 | $1,348.96 |
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 $239.88 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $239.88 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $363.08 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $72.44 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $47.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $338.84 | $537.03 | $537.03 |
Where Connecticut sits
The same service costs 8.9 times more in Oklahoma 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· 19th of 51
$759
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.