How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 (both parts) Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | None (both parts) | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $23.99 Typical High $23.99 | Professional | 26 · Professional part | $19.95 | $23.99 | $23.99 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | TC · Technical part | $30.90 | $40.74 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $245.47 | Facility | None | $112.20 | $154.88 | $245.47 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $37.15 Median $46.77 Typical High $63.10 | Professional | None (both parts) | $37.15 | $46.77 | $63.10 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $10.23 Typical High $27.54 | Professional | 26 · Professional part | $8.71 | $10.23 | $27.54 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $19.05 Median $23.99 Typical High $36.31 | Professional | TC · Technical part | $19.05 | $23.99 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $125.89 Typical High $154.88 | Facility | None | $39.81 | $125.89 | $154.88 |
Cigna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $72.44 | $72.44 | $72.44 |
ConnectiCare Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None (both parts) Typical Low $47.86 Median $83.18 Typical High $204.17 | Professional | None (both parts) | $47.86 | $83.18 | $204.17 |
United Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $30.20 Typical High $74.13 | Professional | 26 · Professional part | $17.38 | $30.20 | $74.13 |
United Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $52.48 Typical High $131.83 | Professional | TC · Technical part | $30.20 | $52.48 | $131.83 |
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 $25.12 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 54 · Surgery only | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $7.59 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $6.46 | $6.46 |
Where Connecticut sits
The same service costs 3.3 times more in Nebraska 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· 25th of 51
$54.95
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.