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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,862.09 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,348.96 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $12,022.64 Typical High $26,915.35 | Facility | None | $512.86 | $12,022.64 | $26,915.35 |
ConnectiCare Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $4,897.79 | Professional | None | $1,445.44 | $2,454.71 | $4,897.79 |
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 $776.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $154.88 | $186.21 | $186.21 |
Where Connecticut sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 35th of 51
$1,549
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.