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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $338.84 | Professional | None | $213.80 | $295.12 | $338.84 |
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 $239.88 Median $371.54 Typical High $489.78 | Professional | None | $239.88 | $371.54 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,398.83 Typical High $3,090.30 | Facility | None | $851.14 | $2,398.83 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $616.60 | Professional | None | $281.84 | $338.84 | $616.60 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $691.83 | Professional | None | $229.09 | $354.81 | $691.83 |
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 $123.03 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $58.88 Typical High $66.07 | Professional | 53 · Discontinued | $48.98 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $181.97 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $36.31 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $169.82 | $204.17 | $229.09 |
Where Connecticut sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 22nd of 51
$355
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.