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 $549.54 Median $660.69 Typical High $660.69 | Professional | None | $549.54 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $30,902.95 Typical High $36,307.81 | Facility | None | $2,137.96 | $30,902.95 | $36,307.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $1,174.90 | Professional | None | $354.81 | $489.78 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $16,218.10 Typical High $19,952.62 | Facility | None | $851.14 | $16,218.10 | $19,952.62 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,737.80 | Professional | None | $524.81 | $891.25 | $1,737.80 |
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 $275.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $66.07 |
Where Connecticut sits
The same service costs 24.0 times more in Arkansas than in New York. 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· 47th of 51
$724
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.