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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $14,125.38 Typical High $16,595.87 | Facility | None | $954.99 | $14,125.38 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,659.59 | Professional | None | $660.69 | $776.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $8,317.64 Typical High $10,232.93 | Facility | None | $851.14 | $8,317.64 | $10,232.93 |
ConnectiCare Setting Facility Modifier None Typical Low $4,265.80 Median $9,332.54 Typical High $9,332.54 | Facility | None | $4,265.80 | $9,332.54 | $9,332.54 |
ConnectiCare Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,000.00 | Professional | None | $602.56 | $891.25 | $1,000.00 |
Health New England Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $2,570.40 | Professional | None | $724.44 | $977.24 | $2,570.40 |
5 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 $426.58 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $645.65 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $91.20 |
Where Connecticut sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 33rd of 51
$912
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.