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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $234.42 | Professional | None | $138.04 | $194.98 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,819.70 | $3,162.28 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $346.74 | Professional | None | $131.83 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $281.84 Typical High $524.81 | Professional | 50 · Both sides | $194.98 | $281.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $1,000.00 | Facility | None | $173.78 | $204.17 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $371.54 | Professional | None | $199.53 | $257.04 | $371.54 |
ConnectiCare Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $302.00 | Professional | None | $169.82 | $239.88 | $302.00 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $389.05 | Professional | None | $102.33 | $181.97 | $389.05 |
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 $69.18 Median $97.72 Typical High $107.15 | Professional | 52 · Reduced service | $69.18 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $27.54 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $104.71 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $151.36 |
Where Connecticut sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 14th of 51
$200
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.