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 $251.19 Median $302.00 Typical High $302.00 | Professional | None | $251.19 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $575.44 | Professional | None | $169.82 | $229.09 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,265.80 Typical High $5,370.32 | Facility | None | $851.14 | $4,265.80 | $5,370.32 |
ConnectiCare Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $794.33 | Professional | None | $239.88 | $416.87 | $794.33 |
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 $125.89 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $50.12 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.12 | $30.20 | $30.20 |
Where Connecticut sits
The same service costs 10.7 times more in Colorado than in Maine. 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· 43rd of 51
$372
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.