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 $398.11 Median $446.68 Typical High $446.68 | Professional | None | $398.11 | $446.68 | $446.68 |
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 $48.98 Median $66.07 Typical High $177.83 | Professional | None | $48.98 | $66.07 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,715.19 Typical High $13,182.57 | Facility | None | $851.14 | $10,715.19 | $13,182.57 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $354.81 Median $676.08 Typical High $1,380.38 | Professional | None | $354.81 | $676.08 | $1,380.38 |
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 $199.53 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $44.67 |
Where Connecticut sits
The same service costs 14.8 times more in Texas 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· 49th of 51
$407
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.