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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $380.19 | Professional | None | $218.78 | $309.03 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $467.74 | Professional | None | $213.80 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,715.35 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $562.34 | Professional | None | $288.40 | $338.84 | $562.34 |
ConnectiCare Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,174.90 | Facility | None | $724.44 | $954.99 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | None | $398.11 | $398.11 | $489.78 |
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 $223.87 Median $309.03 Typical High $524.81 | Professional | None | $223.87 | $309.03 | $524.81 |
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 $120.23 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $120.23 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $234.42 Typical High $245.47 | Professional | 54 · Surgery only | $181.97 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $218.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $169.82 | $218.78 | $229.09 |
Where Connecticut sits
The same service costs 4.6 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· 25th of 51
$331
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.