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 $371.54 Median $537.03 Typical High $660.69 | Professional | None | $371.54 | $537.03 | $660.69 |
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 $363.08 Median $562.34 Typical High $794.33 | Professional | None | $363.08 | $562.34 | $794.33 |
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 $478.63 Median $549.54 Typical High $954.99 | Professional | None | $478.63 | $549.54 | $954.99 |
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 $691.83 Median $691.83 Typical High $851.14 | Professional | None | $691.83 | $691.83 | $851.14 |
Health New England Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
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 $380.19 Median $512.86 Typical High $912.01 | Professional | None | $380.19 | $512.86 | $912.01 |
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 $204.17 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $204.17 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $83.18 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $309.03 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $81.28 Typical High $85.11 | Professional | 55 · Aftercare only | $61.66 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $288.40 | $380.19 | $398.11 |
Where Connecticut sits
The same service costs 3.8 times more in Alaska 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· 22nd of 51
$575
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.