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 $5,248.07 Median $9,549.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $9,549.93 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $6,456.54 Typical High $26,915.35 | Facility | None | $4,466.84 | $6,456.54 | $26,915.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,905.46 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $13,803.84 Median $31,622.78 Typical High $38,018.94 | Facility | None | $13,803.84 | $31,622.78 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,737.80 | $2,951.21 |
ConnectiCare Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,698.24 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,659.59 Typical High $4,073.80 | Professional | None | $1,174.90 | $1,659.59 | $4,073.80 |
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 $501.19 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $501.19 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $758.58 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $102.33 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $707.95 | $1,096.48 | $1,096.48 |
Where Connecticut sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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
$2,188
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.