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 $239.88 Median $316.23 Typical High $380.19 | Professional | None | $239.88 | $316.23 | $380.19 |
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 $194.98 Median $302.00 Typical High $398.11 | Professional | None | $194.98 | $302.00 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,047.13 Typical High $1,479.11 | Facility | None | $707.95 | $1,047.13 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $588.84 | Professional | None | $275.42 | $354.81 | $588.84 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Facility | None | $331.13 | $457.09 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $407.38 | Professional | None | $316.23 | $338.84 | $407.38 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,888.44 | Facility | None | $501.19 | $1,174.90 | $5,888.44 |
United Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $707.95 | Professional | None | $165.96 | $302.00 | $707.95 |
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 $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $181.97 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $169.82 | $218.78 | $263.03 |
Where Connecticut sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 19th of 51
$316
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.