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 $446.68 Median $660.69 Typical High $660.69 | Professional | None | $446.68 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $12,589.25 | Facility | None | $3,548.13 | $4,168.69 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $977.24 | Professional | None | $457.09 | $676.08 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,047.13 | Professional | None | $588.84 | $645.65 | $1,047.13 |
ConnectiCare Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | None | $794.33 | $794.33 | $851.14 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,047.13 | Professional | None | $446.68 | $588.84 | $1,047.13 |
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 $234.42 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $234.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $93.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $70.79 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $457.09 | $457.09 |
Where Connecticut sits
The same service costs 7.4 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· 16th of 51
$708
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.