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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $891.25 | Professional | None | $660.69 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $1,148.15 | Professional | None | $524.81 | $933.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,380.38 Typical High $1,737.80 | Professional | 50 · Both sides | $776.25 | $1,380.38 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,000.00 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,288.25 | Professional | None | $478.63 | $707.95 | $1,288.25 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $891.25 | Professional | None | $371.54 | $616.60 | $891.25 |
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 $489.78 Median $676.08 Typical High $1,862.09 | Professional | None | $489.78 | $676.08 | $1,862.09 |
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 $331.13 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $331.13 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $131.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $66.07 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $457.09 | $616.60 | $616.60 |
Where Connecticut sits
The same service costs 8.5 times more in Wyoming 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
$891
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.