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 $173.78 Median $251.19 Typical High $251.19 | Professional | None | $173.78 | $251.19 | $251.19 |
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 $151.36 Median $263.03 Typical High $363.08 | Professional | None | $151.36 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,630.27 Typical High $3,388.44 | Facility | None | $851.14 | $2,630.27 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $398.11 | Professional | None | $229.09 | $275.42 | $398.11 |
ConnectiCare Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
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 $181.97 Median $257.04 Typical High $512.86 | Professional | None | $181.97 | $257.04 | $512.86 |
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 $85.11 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $173.78 |
Where Connecticut sits
The same service costs 8.7 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· 24th of 51
$282
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.