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 $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | None | $741.31 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $1,096.48 Typical High $1,412.54 | Professional | None | $562.34 | $1,096.48 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,621.81 Typical High $2,137.96 | Professional | 50 · Both sides | $851.14 | $1,621.81 | $2,137.96 |
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 $537.03 Median $758.58 Typical High $1,412.54 | Professional | None | $537.03 | $758.58 | $1,412.54 |
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 $389.05 Median $645.65 Typical High $1,047.13 | Professional | None | $389.05 | $645.65 | $1,047.13 |
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 $524.81 Median $758.58 Typical High $2,089.30 | Professional | None | $524.81 | $758.58 | $2,089.30 |
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 $371.54 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $371.54 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $147.91 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $562.34 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $74.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $524.81 | $707.95 | $707.95 |
Where Connecticut sits
The same service costs 7.6 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· 16th of 51
$1,000
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.