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 $758.58 Median $1,122.02 Typical High $3,467.37 | Professional | None | $758.58 | $1,122.02 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $1,479.11 Typical High $3,630.78 | Professional | None | $602.56 | $1,479.11 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $3,235.94 | Facility | None | $851.14 | $2,511.89 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $2,290.87 Typical High $5,623.41 | Professional | None | $794.33 | $2,290.87 | $5,623.41 |
ConnectiCare Setting Professional Modifier None Typical Low $2,818.38 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,818.38 | $3,801.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $1,548.82 Typical High $4,897.79 | Professional | None | $457.09 | $1,548.82 | $4,897.79 |
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 $426.58 Median $562.34 Typical High $1,737.80 | Professional | 52 · Reduced service | $426.58 | $562.34 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $223.87 Typical High $691.83 | Professional | 53 · Discontinued | $169.82 | $223.87 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $831.76 Typical High $2,630.27 | Professional | 54 · Surgery only | $645.65 | $831.76 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $524.81 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $112.20 Typical High $346.74 | Professional | 56 · Pre-op care only | $85.11 | $112.20 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $776.25 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $602.56 | $776.25 | $2,454.71 |
Where Connecticut sits
The same service costs 4.9 times more in Alaska than in Texas. 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
$1,820
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.