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 $380.19 Median $575.44 Typical High $616.60 | Professional | None | $380.19 | $575.44 | $616.60 |
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 $338.84 Median $588.84 Typical High $776.25 | Professional | None | $338.84 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $891.25 Typical High $1,148.15 | Professional | 50 · Both sides | $512.86 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $1,230.27 | Facility | None | $549.54 | $691.83 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $870.96 | Professional | None | $309.03 | $446.68 | $870.96 |
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 $288.40 Median $478.63 Typical High $645.65 | Professional | None | $288.40 | $478.63 | $645.65 |
Health New England Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $331.13 Median $467.74 Typical High $1,230.27 | Professional | None | $331.13 | $467.74 | $1,230.27 |
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 $223.87 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $223.87 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $89.13 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $338.84 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $67.61 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $316.23 | $398.11 | $436.52 |
Where Connecticut sits
The same service costs 5.6 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· 12th of 51
$575
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.