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 $162.18 Median $229.09 Typical High $371.54 | Professional | None | $162.18 | $229.09 | $371.54 |
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 $154.88 Median $251.19 Typical High $331.13 | Professional | None | $154.88 | $251.19 | $331.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $371.54 Typical High $489.78 | Professional | 50 · Both sides | $234.42 | $371.54 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $371.54 Typical High $478.63 | Facility | None | $51.29 | $371.54 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $537.03 | Professional | None | $208.93 | $323.59 | $537.03 |
ConnectiCare Setting Professional Modifier None Typical Low $125.89 Median $416.87 Typical High $467.74 | Professional | None | $125.89 | $416.87 | $467.74 |
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 $138.04 Median $257.04 Typical High $616.60 | Professional | None | $138.04 | $257.04 | $616.60 |
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 $87.10 Median $112.20 Typical High $186.21 | Professional | 52 · Reduced service | $87.10 | $112.20 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $74.13 | Professional | 53 · Discontinued | $34.67 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $169.82 Typical High $275.42 | Professional | 54 · Surgery only | $131.83 | $169.82 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $56.23 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $37.15 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $158.49 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $123.03 | $158.49 | $257.04 |
Where Connecticut sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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· 20th of 51
$263
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.