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 Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | None | $81.28 | $104.71 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $162.18 | Professional | None | $54.95 | $69.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $5,495.41 | Facility | None | $1,174.90 | $1,949.84 | $5,495.41 |
United Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $234.42 | Professional | None | $91.20 | $123.03 | $234.42 |
4 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 $40.74 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $40.74 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $16.22 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.02 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.13 | $10.47 | $10.47 |
Where Connecticut sits
The same service costs 3.2 times more in Alaska 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· 30th of 51
$87.10
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.