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 $117.49 Median $165.96 Typical High $190.55 | Professional | None | $117.49 | $165.96 | $190.55 |
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 $131.83 Median $218.78 Typical High $295.12 | Professional | None | $131.83 | $218.78 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $1,380.38 | Facility | None | $181.97 | $208.93 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $371.54 | Professional | None | $181.97 | $213.80 | $371.54 |
ConnectiCare Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $407.38 | Professional | None | $134.90 | $208.93 | $407.38 |
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 $72.44 Median $83.18 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $125.89 Typical High $141.25 | Professional | 54 · Surgery only | $107.15 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $117.49 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $100.00 | $117.49 | $131.83 |
Where Connecticut sits
The same service costs 3.6 times more in Wisconsin 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· 18th of 51
$209
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.