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 $1,698.24 Median $5,754.40 Typical High $8,511.38 | Facility | None | $1,698.24 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $165.96 | Professional | None | $97.72 | $128.82 | $165.96 |
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 $97.72 Median $151.36 Typical High $229.09 | Professional | None | $97.72 | $151.36 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $1,000.00 | Facility | None | $162.18 | $186.21 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $288.40 | Professional | None | $114.82 | $162.18 | $288.40 |
ConnectiCare Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
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 $87.10 Median $138.04 Typical High $263.03 | Professional | None | $87.10 | $138.04 | $263.03 |
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 $54.95 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $33.11 | Professional | 53 · Discontinued | $21.88 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.96 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $91.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $91.20 | $117.49 |
Where Connecticut sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 15th of 51
$151
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.