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 $302.00 Median $389.05 Typical High $501.19 | Professional | None | $302.00 | $389.05 | $501.19 |
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 $257.04 Median $416.87 Typical High $524.81 | Professional | None | $257.04 | $416.87 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $616.60 Typical High $794.33 | Professional | 50 · Both sides | $389.05 | $616.60 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $446.68 Typical High $1,000.00 | Facility | None | $389.05 | $446.68 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $741.31 | Professional | None | $204.17 | $446.68 | $741.31 |
ConnectiCare Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
ConnectiCare Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $630.96 | Professional | None | $223.87 | $363.08 | $630.96 |
Health New England Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $912.01 | Professional | None | $416.87 | $645.65 | $912.01 |
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 $251.19 Median $389.05 Typical High $933.25 | Professional | None | $251.19 | $389.05 | $933.25 |
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 $177.83 Median $190.55 Typical High $239.88 | Professional | 52 · Reduced service | $177.83 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $354.81 | Professional | 54 · Surgery only | $263.03 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $331.13 |
Where Connecticut sits
The same service costs 4.2 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· 14th of 51
$417
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.