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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | None | $426.58 | $616.60 | $616.60 |
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 $407.38 Median $630.96 Typical High $933.25 | Professional | None | $407.38 | $630.96 | $933.25 |
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 $562.34 Median $616.60 Typical High $954.99 | Professional | None | $562.34 | $616.60 | $954.99 |
ConnectiCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | None | $758.58 | $758.58 | $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 $426.58 Median $562.34 Typical High $1,000.00 | Professional | None | $426.58 | $562.34 | $1,000.00 |
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 $213.80 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $316.23 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $64.57 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $42.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $295.12 | $436.52 | $436.52 |
Where Connecticut sits
The same service costs 5.0 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
$631
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.