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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $758.58 | Professional | None | $426.58 | $478.63 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $9,772.37 Typical High $12,882.50 | Facility | None | $1,949.84 | $9,772.37 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $1,148.15 | Professional | None | $275.42 | $489.78 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $724.44 Typical High $1,698.24 | Professional | 50 · Both sides | $416.87 | $724.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $1,000.00 | Facility | None | $363.08 | $426.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,174.90 | Professional | None | $426.58 | $724.44 | $1,174.90 |
ConnectiCare Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $1,000.00 | Professional | None | $204.17 | $562.34 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $416.87 Median $1,023.29 Typical High $1,071.52 | Professional | None | $416.87 | $1,023.29 | $1,071.52 |
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 $269.15 Median $426.58 Typical High $933.25 | Professional | None | $269.15 | $426.58 | $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 $218.78 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $218.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $331.13 |
Where Connecticut sits
The same service costs 5.0 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· 25th of 51
$490
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.