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 $426.58 Median $602.56 Typical High $602.56 | Professional | None | $426.58 | $602.56 | $602.56 |
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 $416.87 Median $630.96 Typical High $891.25 | Professional | None | $416.87 | $630.96 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,023.29 Typical High $27,542.29 | Facility | None | $549.54 | $1,023.29 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $954.99 | Professional | None | $524.81 | $602.56 | $954.99 |
ConnectiCare Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | None | $724.44 | $724.44 | $776.25 |
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 $416.87 Median $537.03 Typical High $954.99 | Professional | None | $416.87 | $537.03 | $954.99 |
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 $208.93 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $85.11 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $316.23 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $42.66 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $295.12 | $416.87 | $416.87 |
Where Connecticut sits
The same service costs 6.0 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· 16th of 51
$646
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.