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 $79.43 Median $104.71 Typical High $104.71 | Professional | None | $79.43 | $104.71 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $117.49 | Professional | None | $66.07 | $87.10 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $6,165.95 Typical High $9,549.93 | Facility | None | $3,311.31 | $6,165.95 | $9,549.93 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $218.78 | Professional | None | $85.11 | $114.82 | $218.78 |
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 $39.81 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $39.81 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $15.85 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $11.75 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $10.47 |
Where Connecticut sits
The same service costs 12.6 times more in California than in Kentucky. 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· 21st of 51
$102
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.